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� <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.everettwa.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `? ;j' `'����<s /� �' - L' v��i��i7`-�_�,� % �%'�'� 3 <br /> , <br /> PROJECT ADDRESS <br /> OwnCr Mail Address City State2ip Phone <br /> Tenanl Mail Address Cily Slate2ip Phone <br /> n � <br /> � ��i r'c',/ L E'�T�7c /(.l lc �,�' !� .,�' 9�' 3 J �:;; G�C 5/-Z y'� <br /> Electrical Conlractor Mail Address City State/Zip Phone <br /> � /. <br /> Y <br /> /�/) ,C�C I L � J/L�_, <br /> S ale License Number Coi�tract Price ol Work <br /> <' ' �/ ) <br /> ..� //I �i �C� /( �(i�l :..t �/�/� )Il� <br /> Proposed Use of Building ✓ Contact Person (Plan Reviow) <br /> � f=� �/ 3�0 <br /> Description of Work to Be Done: >//� ." �l I { � � !f l i �(� � � <br /> v <br /> � <br /> ;� �� � ; � � � ,� m�� �> �c� T� _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 bereby cc�fily thal 1 have read and exmnineJ this applicafion and know fhe same fo be frue and <br /> correcf. All provisions ollaws and ordinances goveming this type ol work will be completed <br /> whefher speciGed herein or noL The granfin�oI a permd does not resume fo give authonry to <br /> violate or cancel fhe provisions ol any ofher sfate or local lmv re�uPfing consWclion or the <br /> pedormance ol construc6on. Thaf 1 am authonzed by fhe owner ol fhis property fo perlo�m fhe � , <br /> work/or u�hich application is made and 1 comply wifh the Sfafe Contracrors Law 18.27 RCW and I <br /> 296.200 WAC. 1 / <br /> � !if <br /> — — y %//��,� / C) �- D <br /> Sic�nature Date <br />