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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERI1/�iT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �A - S <br /> 7 I I� �� c ��'n r ��,�_• � d� � <br /> PROJECT ADDRESS <br /> ��d�.c� �C v.�k-� r._ iJ�,�.e 1�„Q.,�a;t� (,�� , `]��I z� 1 <br /> Owner Mail Address City StaMJZip Phone <br /> Tenant Mail Address City Stale2lp Phone <br /> _ �. J- 1. � �•� �-� R-�c �t-6or P_(ti>n��u� l� �< < �< d lv, `�j2�S <br /> E�eClriCal Contraclor Mail Address City State/Zip Phone <br /> L � ��� �� r� 3u � �, �,z-� <br /> Stale License Number Conlract Price of Work <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> � � <br /> Descriplion ol Work to 6e Done: �L1L 'L 1.9-�.� ���-.��u � <br /> � <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 certify Ihaf 1 have read and exarnined this application and know fhe sAme to be Vue and <br /> correct. All provisions ollaws and ordinances govenung fhis type o/work wiN be complefed <br /> whefher speafied herein or not The�ranfing o(a pemut dces nol presume to give authonty to <br /> violafe er cancel the provisions o(any other stafe or local law regulating consfruchon or the <br /> peAonnance ol consfn�ction. That I am outhonzed by fhe owner ol this property to perlonn(he <br /> �vork lor�vhich applicafion is rnade and 1 comply wifh fhe Sfate Confracfors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> � __��- <br /> � --�- �, �� 1�,� <br /> Signature Date � � /- � <br /> � CW���GS�/ <br />