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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 /> �� �:� <br /> �,.� <br /> � <br /> �����G��_���i ���� `� l/� -fl�� <br /> � <br /> PROJECT A�DRESS <br /> �/c S: 2 $ <br /> - 53�� <br /> ' �, �1/� ��A- ,� P�ti /�z:�3 �- v��rr �1/�i ��6 <br /> Owner A1ail Address City Slate2ip Phone <br /> N�li <br /> Tenant Mail Address City Slate/Zip Phone <br /> Se /� <br /> EleClrical ContraCtor hlail Address City 51ateRip Phone <br /> ���� <br /> State License Number CoNract Price of Work <br /> �P��i �' r�-1"�t � <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> n (' i r - <br /> Descriplion o(Work to Be Done: I�p�I�.�e Q� Ch2/n/h 9 �n o� 5r �u bc� �Ll�yyj'�� <br /> —'f— <br /> i 1 ���� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F�E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y thaf I h:�ve read and examined this applicafion and knowlhe same fo be Irue and �UIrU 1 �l\ <br /> conecf. All provisions ollaws and ordinances governing(his type ol�vork will be complefed <br /> whefher speciGed herein or noL The granfing oI a pemut does not resume to give aufhonty fo <br /> violafe or cancel the provisions ol any ofher sfafe or local la�r reguPfing cortstruchon or fhe <br /> perlonnai�ce o/construcfion. That 1 ain authonzed by the o�rner o(th:s property to pe�fomi the <br /> work(or which application is rnade and I comply wifh Ihe State Contractors Law 7827 RCIN and <br /> 296200 INAC. <br /> , , <br /> .`-tit.�_:�� � `'�tj��,Ly.�.r--� �— .'' - �� <br /> � Signatwc Dale <br />