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_ � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WP, 98201 <br /> 425-257-8810 - FAX 425-257-8857—w�n^N.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �--�;_� ;- ,��, ��c�r:�:� <br /> PR JECT A6DRESS <br /> ���j' <br /> ��-�j -��Y`7, � � i <br /> � -��ri i�t� 1 � �✓ u � �� > >�I-�i <br /> OWner MailAddress City Slate/Zip Phone <br /> .�\�YIL <br /> Tenant Mail Address Cily StalelZip Phone <br /> - 1 .� � ` f ��U � � - <br /> Electrical Conlraclor Mail Address City Stale/Zip Phone <br /> (`��-r"T-� ����.\\ �`7 �;) ` <br /> State License Number Contrect Pri e of VJork <br /> L.V i�" /t>� I C - — <br /> � Proposed Use o uilding� Conlact Person (Plan Review) <br /> I <br /> Description cF Work lo Be Done: <br /> i <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS �S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby cert�ly that 1 have read and examined this applicafion and know fhe sarne fo be true and <br /> correcc All provisions al laws and ordinances governing this type oI work will be cornplefed <br /> whelher speci4ed herein or not The granfiilg o/a pemut does nof resume to gi;�e atdhonty to <br /> violate or cancel the provisions of any;ofh .,tafe or/ocal lau�reguPting construchon er the <br /> pedomiance o/consfruction. Tiial�Y�'rn thorized by fhe owner o/fhrs property tu perform fhe <br /> werk lo�which application is� de�ri omply wifli fhe Sfate Con(ractors Law 18.27 RCW and <br /> 296.200 WAC. i <br /> � �' �.- i <br /> , ; <br /> i � <br /> f . <br /> �-, ignaNr� Date <br /> r <br /> iG�� S- � '1 <br />