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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 9��� 1 <br /> ,�C�i�� l�r�� ��v� Cv�.�e,l-� � l.� �� <br /> PROJECT ADDRESS <br /> I� ve.J .J � �,.�. ��lb f C, � Fl�r F ��lk tJ�� Y�,�-ol <br /> OWner Mail Address City Stale2ip Phone <br /> r--- <br /> Tenant Mail Address Cily State2ip Phone <br /> � �..., « �i� 6 � i�a� �t� - � ��� « s..�i� ._�(� c�,t �sa�o �"12y��3a-9o9� <br /> Ciectrical Conlraclor Mail Address City State/Zip Phone <br /> '� I �`1 �v�t <br /> Stale License Number Contract Pnce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion ol Work lo De Done: �+-J ?�"+'✓� �L <br /> NOTE: WIRING IN NOfv-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(}�t1�af 1 have rend and examined this applicetion and know fhe same to be fnie anA <br /> correcL All prows�ons of laws acd ordinances govemmg this q�pe oI u-ork will be compfeted <br /> whether specilied hemin or noL The�ranting of a pemuf does noll�resume to give authonty to <br /> violate or cancel the ruovisions ol��ny other state or local la�v regu afing construction or the <br /> peifomiance ol consfruch n. That I am aufhonzed by fhe owner o/this property b peAomi the � <br /> �vo�k lor�vhich applicaho�is maJe and I conrply with the Sfate Contractors Law 18.27 RCW and <br /> 29G.200lNAC. / - � <br /> , �' ,��� / / ,���� -� ���� <br /> � <br /> '� 'L-z�-� �/ a`_i(o� � <br /> - S na.me Date <br />