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i <br /> 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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �}) �' /���c ,: S i� ( — Lv'r' i ='� c{�� `1 �' .'� :? <br /> PROJECT ADDRESS <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �nr[%�' i �� �E�= P-rc �'Ur'Y�'f� �� '� `��� 3'l (.5�•���5�/-�/`l ' <br /> Etectrical Coniractor Mail Address Ciry Slate/Zip Phone <br /> �G i.0 �I[' � `I �%/� J <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descrip�ion of Work to Be Done: `-� � � " ' r> i l f� � r' �� �T �� ?Z' <br /> i � <br /> �. <br /> !� ��'� � 7f i /7r :��;T � %7'- <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 3705 <br /> I he�eby ccrti/y Ihaf 1 have read and exnmined fhis application and know the same fo be true and <br /> correcL All provisions ellaws and ordinances goveming fhis type o!work will be completed <br /> whether spea(ed herein or noL The granfing o/a pennd does nol resume to give aufhcnry to <br /> violafe or cancel fhe provisions of miy o�her stale or local law rec�uPting constn�ctiun or the <br /> peAormance o/consPrucfion. That 1 am aufhorized Gy tbe o�vner ol this property to perform fhe 1� <br /> woik Ior whrch application is made and 1 comply wilh the State Contracfors Law 1827 RCW and <br /> 296.200 WAC. -- — � ,� n � <br /> �; �� 'J� o;/ C� ; <br /> �i`i <br /> t <br /> � �Sipnalure � Dale <br />