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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 /> I ?�"l-C: l-.r:.��I ��,, � <br /> PROJECT ADDRESS <br /> �� � l , � � t 21c•-EaSC <br /> I'l�m�-I< l7 (Tlo� �c �Aw2�= l.v 1 q4'�<<- 1Z>- <br /> Owner Mail Address Ciry Slate/Zip Phone <br /> 5A�ti1� � <br /> Tenanl Mail Address Ciry Stale/Zip Phone <br /> / <br /> Eleclrical Conlraclor Afail Address City SWle2ip Phone <br /> Stale License Number Conlracl Price of Work <br /> Proposed Use of Buildinc� Conlacl Person (Plan Review) <br /> Descriptionof�VorkloBeDone: b'1'�1n�� �'���+'�'���'����'1 �w-��' `4t%i��� Li���S�l ��''�5;?LC�v��{ -��.�1 <br /> � 1 �`•' �v�n �� '1 r -�ft �t�� �'�k�l M�� ���iY+�rtx�ti� <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 /> 1 hereby certily fhaf 1 have read and exemined fhis applicafion and know the same fo 6e frue and <br /> coirecL All provisions olla�vs and ordm��nces c�ovemmg this type ol u�ork will be completed <br /> �rhefher speciGed herein or noL The granting of a permd does nof presume lo give aufhonty to <br /> violafe a cancel the provisions o/any oUier state orlocal law regu/ating consVuction or the <br /> performance oI cons(rucfion. That 1 am autho�ized by the owner o/this propeAy lo perlonn Ihe <br /> �ro�k lor�vhich applicafion is made and 1 compty�vith fhe Stafe Contractors Luw 18.27 RCW and <br /> 296.200 WAC. ������- <br /> i <br /> �-,�' �'� '� � � <br /> � , �. � < < , C�.- z1�/:<.: I-/, I <br /> Signature a� U <br />