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ELECTRICAL PERMIT APPLICATION <br /> �iTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I � �� <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org �dc1�t�•�_6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�l//o h��•.,. f� �9�c. r:�,u� <br /> PROJECT ADDRESS � <br /> S`2 Sr-33o'�7� <br /> �(iG� .Lti,,�s/�' /� ��r �Qi7� ��u'-�^�� 6n� `J,�1oL <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenant Mail Address Cily Slale/Zip Phone <br /> S� �-c' <br /> Electrical Coniractor htail Address Ciry Slate2ip Phone <br /> ���a= <br /> Slate License Number Contract Price of Work <br /> 54•r�� <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> Description of Work lo Be Done: ._�rlr�.ia �,��J � h�a S�" <br /> NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �S <br /> I hereGy certily fhaf 1 have�ead and examined this applicafion and know the same to be tnie and �i��2 U�J <br /> correct. All provisions olla�vs and ordinances governmg fh�s type o/work will be complefed <br /> �vheNier specified herein or noL The granting o/a penmt does nof resurne fo give aulhonty fo <br /> violate or cancel fhe provisions o/any olher sfafe or local law reguPtin�construction or the <br /> perfonnance o/consfruclion. That I am aufhorized 6y fhe owner ol this property fo pedam the <br /> work/or which application is rnade and 1 compty wilh the Stafe Contracfors Law 18.27 RC W and <br /> 29G.200 WAC. <br /> - ��, '/�.��// / �-/�- �S <br /> Si�nature ✓ Datc <br />