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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-885i —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED Fl:OM 8 AM TO 4 PM <br /> � � - <br /> � �, �`��/ . ; �t � <br /> :...,� <br /> PROJECT ADDRESS <br /> Q �zS <br /> !�_1'�l<( l_�11i� � ! �7r�i>>(. f %��, / .G. r�.jC G�f� �-K ;�ZrG�:f l�� �1�� 3SG 7�G'7 <br /> � <br /> Owner Mail Address Ciry State/Zip Phone <br /> ���r� L <br /> TenaN A1ail Address City Sla�e/Zip Phonc <br /> ���.�.Vl�?t. <br /> Eleclrical Contractor ntail Address Ciry Slate/Zip Phone <br /> Stale License Num6er Contracl Price o(Work <br /> Proposed Usc of Building Contacl Person (Plan Review� <br /> l <br /> Description of Work to Oe Donc: �t�� � CWU�- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�tily fhaf I l�ave read und exarnined this applica(ion and know fhe sarne to be true and �� v�� Z C��� <br /> co�7ticL All p�o��isions olla�rs and ordinances govemmc�fhis type ol�rork will be complefed <br /> trhefher speciGed her�in or noL The g�anfing o/a pernuf does nof �resume to pive aidhorrty to <br /> violafe or cancellhe provisions ol,�ny ofher sfate or Iecalln�v reyulating construcfion or the <br /> performance o/constnictiat Pmt I am authorized b}�fhe oisner o(this property fo pedorrn the <br /> �ro�k Ior whrch applicalirni is made and 1 cornply�rifh the Sfate Cont�acfors Lew 18.27 RCW and <br /> 29G.200 WAC. <br /> - _ <br /> �-.... . <br /> ��_�.� � � .. -< -�.-�t � ( O <br /> Si�nature Date <br />