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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 /> � � f � ��• l� .'� F-- !�� ;��� L � <br /> PROJECT ADDRESS <br /> T � f <br /> �r� � � �1� -`�,� 'riL � b � IU��� <br /> Owner Mail Address Cily Stale/Zip Phone <br /> Tenanl Mail Address City SWIe/Zip Phone <br /> � � ', (>���� �/ I`' 1_�i � �� �'l �'�L '!-� il/�c'' I'�Co�,' � 1�. (��,?, ('—> > > S � _ �c � � l <br /> Electrical Conlraclor Mail Address City Stale2ip Phone <br /> / << <br /> ,�� 'i",l.•7 � �� � ' �, .� C.��' <br /> ;�� � 'i L��L [ l 7 ! 1- �1 <br /> Stale License Number Contracl Price of Work <br /> , � �, <br /> �� � 1�/ � L� �_. <br /> Proposed Use o(Buildinc� Conlacl Person (Pian Review) <br /> Descriptian af Work lo Ba Dona: I��I � �`,�, �� �t� �- �i ,^'/< � � - i�"� �� ,�1 �% �.1�� �� <br /> I " f ! - < ( ��� V � ��1�� �,�U /( l. , nf-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 certily(hal l bave mad and exarnined fhis application and know the same to be true and <br /> coriecL Al!provisians o(laws and ordinances govemmg fhis type oI work will be completed <br /> whelher speafied herein or not The granfing ol a pernuf does nof preswne to give aufhonty fo <br /> violate or cancel fhe provisions o/any ofher sfafe or local law regidafing construcf�on or fhe <br /> performance o/constniction. That 1 am authonzed 6y fhe owner ol this property fo peAonn the <br /> work for which applicafion is made and I compty wifh fhe Sfafe Conhactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> . • � �`o <br /> .L. ' �i �� i� .���.,. Lj - � . �� �- <br /> SignaWre Dale <br /> (�, pS�- S� <br />