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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 a�'�l <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L`��a� <br /> � <br /> � �' , - L U�r� G�i3 r�ZC� <br /> lS::%�`� 1 ,:� n�� 5T�'w S"z-� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip Phone <br /> =��+� ��a ic�� (Mousr2,� T ��'2c� r,Jri `�YG"L�� i?-� �C�S'/�(p <br /> Tenant MailAddress � City State2ip Phone <br /> d,f �KE C�Ucti ����t�' �JA �iJoz¢� 425-�So -� <br /> EleClficalConlfaClor MailAddress Ciry State2ip Phone <br /> cw <br /> �.� �KEN�o����r2 4S r�o - <br /> State License Number ContraG Price of Work <br /> � /a�/li.^�� (�17�i� L-�,�//l�hl�)�� �I���"�7�t.�1/ <br /> Proposed Use of Building � Contact Person (Plan Review) <br /> DescnplionofWorktoBeDone: N5:? L(, � � ���G F�LL� ''��CK L� 't �Gti,.._ <br /> i j <br /> L� i/ I � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWA.`(S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRi(y that I!;a.a read and examined this application and know the same fo be true and C'I O� ��l <br /> correct. All provisions o/laws and oNinances goveming th�s type of work will be.completed L <br /> whether spec�fied hc:min or noL The granting ol a permd does not presume fo g�ve authonty to <br /> violato or cancel tbe xovisions o/any ofher state or local!aw regulating construcfion or the <br /> perlomiance o/cons�rucfion. That 1 am autbonzed by the ownero(this propeAy(o peAortn tF,e <br /> work!or which app6cafion is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> • <br />