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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 - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � / � <br /> / �;� � i r�, ���� ,�'�n' v� <br /> r <br /> PROJECT ADDRESS <br /> I i <br /> �I y / �[ ` � <br /> l C• 1' :S �`l��F' �/� � (�� 1-<iiGil _��il i/ir.��£'// ` i�t. �� <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant Mail Address City Slate/Zip Phone <br /> � � t-� .� .� � `k � { l . c.s"•7 . ,ST�G" .((0��%0=0 <br /> i4:viJ IE�..�9!'�'�liC�� � PC � ;i � /, .>'/ /) f� 1�I �C%f' �i' /,'i�o c<. (i. ., i :i <br /> Eleclrical Conlraclo� Mail Address Ciry Slale2ip Phone <br /> �� / ��� / l/ � � <br /> /+.ae"'�, ,�iY��7i �}�� 7 f�/� .^�.�i-`iri.� <br /> State License Number Conlract Price of Work <br /> 7 � <br /> �' r-, 1i�'�tiri( r` <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> Descriplion of Work to 8e Done: ('/c:,,:. : � ?i�:: ;t,,, � •„ ,. . � <br /> / � ,/ �/—/7 // <br /> 4v_F_� �1v�i�i��F• �� i � 1-�S �. z - 7ar kiic./C�� �` F-a. �' �C�c t�4i—_ <br /> � �:� / �O r �Y ,' C� <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 certify that I have read and examined fhis application and kno�v the same fo be true and <br /> correcf. A/l provisions o/laws and oidinances governing this fype oI work�vill be completed <br /> whefher specdied herein or noL The granting o/a perrnd does nof resume to�ive authority to <br /> violate or cancel the provisions o(any other state or local la�v reguPting consfrucUon or the <br /> peAormance o/consVuc6on. That 1 am autf�drized by the orener o(fhis property to peAorm fhe <br /> work/or which applicafion is made and 1 cpmply wilh the Sfate Conhactors Lau• 78.27 RCW and <br /> 296.200 WAC. � / <br /> � ��, � •;i <br /> -//.N-- / �,/✓�/.,�i J. 7 (, _L� S' <br /> � �Sinnature' " Date <br /> E �So7-i2.3 <br />