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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT F'ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 ' ` 8_0� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �oga�--aZ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'22 � C'�iK�s h�� <br /> PROJECT ADDf2ESS <br /> �U�N �U�L hZZ� L��I�LS �Ul� EV�I�: � �L�� `�Ju�I <br /> Owner A1ail Address City State2ip Phone <br /> ��ltii�. <br /> Tenanl hlail Address Cily Stale2ip Phone <br /> �tU�C <br /> Eleclrical Conlractor nlail Address City State/Zip Phone <br /> Slate License Number Conlracl Price of Work <br /> ��tSi�� ��vc� <br /> Proposed Uso of Buildiny Conlacl Person (Plan Review) <br /> Dosc�iplion of Work lo[3c Donc: �\�- _ ��/�TL. �-1-�--� I ���'%��- >�N��...- ' L" (\ �'� I �1V� <br /> ��(11�'k 10,�1� T� 1NL`c�ei2 2vvk (h�i �o' �w�� �-� -ue�� � <br /> `:J//I� /1i1�t1 l;,)IR ��� � r�f�� l '> I-�� k�`-I�Rco�� (' 1/�CUI I5 <br />� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACFWAYS. MC OR AC CABLE. <br /> I <br /> h CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> -, —, <br /> ���'�IC�7 _� �'� C <br /> 1 hereby certily fhaf I l�are read[�nd exarnined fhis application and kno�r the sarrte fo be 6�ue and <br /> correcL All provisions olla�vs and o�dinances goveming fl�is type oI work�vill be conrpfefed <br /> whefher spea�ed herein or not. The granting oI a pemut does not resume to giro aufhonfy fo <br /> violafe or cancel the provisions ol any other slate or local la�v reguPfing construction or fhe <br /> peAomiance o/consfruchon. That I am aufhorized b}�fhe o�rner of fhis property to pedomi!he <br /> work!or which application'is mndo and 1 comply wifh U�e State Confractors Law 18.27 RCIN and <br /> 296.200 WAC. � <br /> v- 1 7 �� �a� <br /> Signalure � Dale <br /> � <br />