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i ' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g _S/� <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org r����_D3� <br /> L <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i."��'� �-��L:ill <br /> PROJECT ADDRESS <br /> / i ���l%COl l'l <br /> Owner Mail Address City State/Zip Phone <br /> / <br /> ..l=�iL'/ )/; ��/7 <br /> Tenanl Mail Address Cily Slale2ip Phone <br /> 1�v %an�c ZyOO � � �L� <br /> (1,-«>>�7� ��r-�r �r u„� �lf3z�3 �o-�sso <br /> Elecirical Coniraclar ldail Address City SIa1MZip Phone <br /> 00 <br /> �� �:� � i,c � ��3c� 250 <br /> State License Number Contract Price of Work <br /> Pro{wsed Use of Buildin� Conlact Person (Plan Review) <br /> Descripllono(WorktoDoDona ��✓��-C_� ��C�i�( cl� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> S�D°" <br /> — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I� _ �3` <br /> 1 hereb}�ccrtily Oiaf 1 have read and exarnined this applicafion end know the sarne to be truo and � <br /> con�ecL All provisions ollaws and ordinmicos go��emmg fhis type ol work will be complefed <br /> n•hefher specilied herein or not The granfing ol a pennd does nof resume to give authonty fo <br /> violofe or cancel tl�e provisions o/any otber state or local law reguPfing consfrucfion or fhe <br /> perforrnmice o/consfruc(ion. That 1 am aidhonzed by fha owner ol flus property to perfomi the <br /> work lor which application is made and 1 comply wifb the Sfafe Confrecfors Law 18.27 RCW and <br /> 29G.200 WAC. / <br /> ��%'Cl��J ' ! <br /> Si�n�ture Date <br />