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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �o � 6- 0 9 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �y O�!/D- a7� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> J ��./ \Jr�y-�� ��J�1�C J <br /> FROJECT ADDRESS <br /> �C..O �' �t��P`"�'��2 � I��� �n�f` �il�. C�IJ�;�� lZ���� c� ���=�97 <br /> OwnCf M1tail Address City State/Zip Phone <br /> Tenanl Mail AAd�ess Cily State/Zip Phone <br /> �xs;'i� �f�c•�'r;C, � c� Q?�G � �-10 C�J� � U.� of��� �s�i a��'-t I <br /> Eleclric2l Conlraclor M1tail Address City Slale2ip PLone <br /> �,���-s �i; 15 "' �.1 � �Sc�c7�—O <br /> late License Number Contracl Price of Work <br /> �pS�dl�P�1( `[ <br /> Pro� ased Use o(Building Conlacl Person (Plan Review) <br /> Dc ^ription of Work lo Be Oone: � • �`�_hi�� l� �� <br />-� <br /> NOTE: WIRING IN NON-DWELLINGS IS R[�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 'il / � <br /> I hereby cerlily fhat 1 have read and examined tl;is application and knou�Ihe same to be tnie and l�' ' � �' �,�� <br /> wrrecL All provisions o!laws and ordinances governrng Ihis type o/�vork will be compleled <br /> �vhelher spealied heiein or nc� i hc granfing o/a pennd does nof p�esume fo gn�e authonty to <br /> violale or cancel fhe Ivovisions oI an}�ofher sfate or local law re9ulalin�consfrucfion or the <br /> performance o(caistruction. That 1 am authorized 6y Ihe o�vnei o!thrs propedy to peAorm fhe <br /> work lor�vhich application is made and 1 comply wifh the State Cont�actors La�v 78.27 RCW and <br /> 296.200 WAC. <br /> ��� �-- 7'--' I�_"/}-O`� <br /> �-�_""i'`—� Date <br /> . igna�urr. <br /> � <br />