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/ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 jrp�.7--�s <br /> 425-257-A810 - FAX 425-257-8857- www.everettwa.org • �.O�b�'�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> � LJGL � ,'1r7v'S. � .� ��� V� <br /> PROJECTADbRESS � <br /> OWner ntailAdtlress Ci�y Sta�c/Zip Phcnc <br /> 1 <br /> � � �� —� <br /> '� i._ �_� �[,'Ljr=��`��R �� � �: C '�-.. � y^C�xbSi'�/ � Vc —b'° 1 ° �-' <br /> Tenant Mail Atldress City S�alelZip Phone <br /> - , � � � �r � �—' � �C' /� �o i c �Zv� �i 5er���� �1� C,<�� 3L�� -� ���� <br /> � ',1 � / \��. i C `� I C_ C- � <br /> ElectricahContractor ldailAdtlress City State/Zip Phone <br /> �_�!N ��Ec � ��51-� `� C� , �I Z 5 .� <br /> , <br /> State License Number Contracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � ` I <br /> Description of Work to Be Done: ` • � � �� '�� r �r, I'^ ���� �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �'z� 3 �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily fhat I have mad and examined fhis appfication and knuw the same to be frue and <br /> correcf. All provisions of la�vs and ordinances govemmy(his type ol�vork will be complefed <br /> whefher speci6ed herein or noL The granfing ol a pernut Aoes not p�esume to give aufhority fo <br /> violafe or cancel fhe provisions of any ofher sfafe or local law regulafing construction or the <br /> pedormance o/consVucliun. That I am authonzed by the owner o�this pwpetly fo pedomi the <br /> work lor which applicafion is made and 1 comply with the Sfate Confractor Law 18.D RCW and <br /> zss.zoo wnc. <br /> ��-� 1� � � � S — <br /> SignaWrc Date <br /> � �� � <br /> i _ �. % <br />