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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `�'" � ��S / �J <br /> � /' /N2,2i_/7� M�� <br /> PROJECT ADDRESS <br /> �, /' � � nr p <br /> i. •F iC i dFF�u.v�' ���� /a•:�c ,5c�i_- � di�Q:r� /J� l 6�`�// Zc-�. �1-r�//.3 <br /> Owner Mail Adoress City State2ip Phone <br /> Tenant idail Address City Slate4ip Phone <br /> �' �'i:.,,,- C c.-�.c _ <br /> Eleclrical Conlract r Mail Address City State2ip Phone <br /> Slale License Number Conlrad Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Jesr,ription of Work to Be Done: �'r'�' /�l�Lc:�L" ?�TZ-� l �-�c;t'-C—C��'ca.�.v� / <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ; CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hemby certily fhaf I have read and examined this applicatien and know the samc-(o be true ard <br /> co�-.ecL All piovisions olla�vs and ordinances govcrning this t}�pe o/work will be completed <br /> whether specAmd herein or not. The�ranting ol a permd does not presume to give authonty(o <br /> violafe or cancel the provisions o/any other stafe cr Incal faw regulating construchon or the <br /> perlormance olconstruchat Thaf I am authonzed by fhe o�vner of this property fo pedorm the <br /> work/or which application is made and 1 compty with the Sfafe Confiactors Law 78.27 RCW and <br /> 296.200 WAC. , <br /> � / i <br /> i <br /> C � � �� �G ��L��,� <br /> Signature ate <br /> �' i�5�q -055 <br /> -� <br />