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ELECTRICAL PERMIT APf�LICATION <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 /> APPLIC4TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> J - � '� /� ��= S <br /> ; i �, � <br /> PROJECT ADDRESS <br /> � �7 L l I-� � � �_ ��%V'; r <br /> Owner Mail Address City Stale2ip Phone <br /> Tenanl Mail Addross City Slale2ip Phone <br /> ) .��37 <br /> ly )�7 � \�f�I� G c �. �lt �l � C.^ �/ �� � i\a !i�i 'LlJ L �/tii,.ie�v,�� C.i'1 <br /> Electrical Conlraclor M1tail Address City Slate2ip Phone <br /> �-J7 ��- ZSZ -�55 �� <br /> �.�-�JJ ��1�" �- S \ 21 O�� <br /> Slato License Number Contract Price of Wor4; <br /> Proposed Use of Build nc� Conlacl Person (Plan Review) <br /> i � - J <br /> Description o(Work to�o Done: 1 ��— �^-� � �� ! �C � � � ���� "� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREO TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERET!LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ccrti(y lhat 1 have read and examined fhis applicafion and know Ihe same to be We and <br /> correct All provisions o/laws and ordinances goveming Ihis fype ol work�rill 6e completed <br /> �rhefher speci62d herein or noL The c�ranting of a pennd does not presume to give authonty to <br /> violale or cancel the provisions o/any ofher sfate or local lt+w regu/ating construchon or fhe <br /> perfomiance o/,constnfction. 7hat 1 am aufhonzed by the o�sner o/fhis property fo perfomi fhe I <br /> n�ork for�vhich applicnfion is mado and I comp/y wifh the Slate Confracfors La�v 18.27 RCW and n ` L <br /> 296.200 WAC� i ",� <br /> � ,' ��� � � ���� <br /> � � � �� � . , <br /> , <br /> Signature � . Date <br />