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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �1_�4_pG) <br /> 425-257-8810 - FAX 425-257-8857-vwvw.everettwa.org Z �� a <br /> C-o9/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � TJ I °� l`�c-z.:�i r �f vr' <br /> PROJECT ADDRESS <br /> � �s, ��r�i�r� �i����ls � �� �Si`/ 1Y��� r;t/f rr�ws��/� �v�9 S'b"� '7/���0)�7o-c�� <br /> , <br /> Owner Mail Address Clry SUte2ip � Phone <br /> / „<c, �'rrv ��- c a 7/`� Nc7uiri ✓f//t 6`zitJ2e�T �,/sA �'7 ���1 i.� <br /> Tenan Mail Address ary S�ate2ip Pnone <br /> ��T f. �!�- �JLQ /Yl�h / S.r�+.z- <br /> EleCtrical Contrector Mali Address City Slate/Zip Phone <br /> o'� <br /> ,�DD <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Buitding Contacl Person (Plan Review) <br /> DescriptionofWorktoBeDono: �ct7 �nl � �- !J nLt/C f Ul2 FS/�rLr•>SG ti1.�P�h'i�i� <br /> —'T— <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y fhat I have read and examined this application and know Ihe seme to be true and <br /> conecL All provisions ollaws and ordinances goveming this type ol work will be completed <br /> whether specified herein or noL The granting ot a pemut does nof presume fo give authonty fo <br /> violate or cancellhe Provisions ol any ofher stafe or local law regulating consfmction or the <br /> performance ol consfnicfion. Thaf 1 am aufhonzed by fhe owner oI fhis property to pedomi fhe <br /> wo�k Ior which applicntion is mado and 1 comply wifh Ihe Stafe Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ;� , . . . �0 <br /> , �- ; <br /> �.��,-- ; %�;;r=.4-. 2 <br /> � alu2 Date �� <br /> �" <br />