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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETT, WA 98201 <br /> a25-257-8810 - FAX 425-257-8857—www.everettwa. �rg <br /> A?PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBR 3 CREDIT CARDS ARE NOT ACCEPTED <br /> ��-�-�`�—�—.-��T �1 cllLl �����%T <br /> PROJECT ADDRESS <br /> 7 f` i L� S�l�cYYl <br /> Owner Mail Address City Sfate2ip Phona <br /> — �Q.�LP/'tiJ <br /> Tenant Mail Address City State/Lp Phone <br /> i <br /> l�C � rc�t�eifTic�� �/_s� �caa. I�it �.�crt�.��✓ <br /> � �urf a4Zti I u2C �7_C .�� <br /> ElecUical Contractor Mail Addresa Cily gp��p phory <br /> l�CX I C�r ,F9(o5[..S .��iY�'� <br /> State Ucense umber Contract Pnce of Work <br /> �K-ti'7 �TI�s <br /> Proposed Use of Baitdfng Contact Persan (Plan Review) <br /> Description of Work to Be Done: - �J <br /> , - -� . --. <br /> �� - ' sci�z �o'< ��/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I he26y certily that 1 have read and examined fhi�applicaflon and know fhe same to be hue and <br /> Icorrect. All provisions o/laws and orainances govaming this type of work will be completed <br /> whefher specified herein or not. The granting ot a perm�t does notp resume to give authority to <br /> violate or cancel the provisions o/any other sfafe or local law regulefing consfruction or the <br /> I peAormance ol construchon. That 1 am authonzed by the owner o/th�s property to peAorm the <br /> Iwork/or which application is made and 1 comply with fhe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WA C. � <br /> � ��,.�•l�l `' F.��-- r�a �o� <br /> Signature Dat — � <br /> /� -/3 <br />