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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 `J ,�.j � <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org (� <br /> C p�Q�'--0�/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM r <br /> ���f);� � ,����_l�-,��; <br /> PROJECT ADDRESS <br /> i <br /> � r?�'�f �-u�11�—.E,%l�,r�� �, ,n�' f1-���' Fi�Fr �,. J �`� �j�'�( y-as�- a <br /> Owne� M�il Address Cily State/Zip Phone <br /> Tenanl Mail�ddress Cily Sta�e/Zip �hone <br /> ..�- „�cJ •�v oJU� <br /> /���/T F�C�I�_)�J c�� �(��.� d t �b.� . �J�r�l'h�Sh W � �b�! c� <br /> B eclrical COntraclor Mail Addmss Cily Slale/Zip Phone <br /> �, � � ) !� �7 ' � !��� . O J <br /> Sla e License Number � �ontracl Price of Work <br /> Proposed Use o(�uilding Contacl Person (Plan Review) <br /> Descriplion of Work to De Done: �[-L,1 C� � (�r / � t IMc� i �il �Y�c�.Mn '�M ✓ <br /> c' � .(��� �=��n � � �= `'�- �� - <br /> F�i�� • <br /> \ NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 ha��e reaAand examined(his applicatior and kno�v the same(o be true and <br /> conecL All provisions olla�vs and ordinar�ces got�enung this type ol tvork will6e complefed <br /> u�hether spec�lied herein or not The grantint�o/a pemut does nof �resurne fo give aufhonty fo <br /> violafe or cance fhe pror;sions o(any ofher state or local la�v regulaling consfrucfion or fhe <br /> per/onnance oI nstnicbon. That 1 am airthonzed y_U�e o�vn oI tlus property fo pedonn fhe <br /> �vork(or which a a�icafior ' de and 7pty � �the Sfafe ontractors Law 18.27 RCW and <br /> 296.2001NAC. � ` �j <br /> �_ �� „ U <br /> �; _. 3 �5 �7�3 �p�° ' <br /> —. : — i� <br /> SignaWr � Date <br /> 1 <br />