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ELECTRICAL PERMIT APPLICATIOi�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -wvwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /f/o/ ��,��;i/�;c� ��,, /�i��, �i y <br /> PROJECT ADDRESS � <br /> i' / .� lJ.�l: � 7✓YO� '�/!��/7Jd'/.�r " ✓.�J.�u��L'a.�D �dQJlo- '�/'..QS/��J'/� •�G�'Y,� <br /> Owner Mail Address Cit� State/Zip Phone <br /> Tenant Mail Address Cily Stale2ip Phone <br /> //�� /��.�;k,rl L 'f,fi!�,r_ /�'7 cY �7 .��Y'=`��O.S lcl l"/�lllo.JG/S 7d"�D:�/ 'T�7/%�7�`-�/lr� <br /> Electrical Contr Ctor Mail Address City SlalelZip Phone <br /> � �l.�l L �/D �.1� � �AD �' <br /> Slate License Number Conlracl Price of Work <br /> Proposed Usc o(Building Contacl Person (Plan Review) <br /> Description of Work la Be Done: � �� /1 �w f' L� <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 /> 1 here6y certily that 1 have read and examined fhis application and know fbe same to be fn�e and <br /> correcl. All provisions ol la�vs and ordinances governmg this type ol work will be completed <br /> whether spea6ed he�ein or noL The�ranfin�o/a pemid does nof •esume fo give authonty to <br /> violate or cancel fhe provisions o/any ofher stafe orlocal law reguPting consWction or the <br /> pedormance ol construction. That 1 am aufhoiized by the owner of fhis property fo perlorm the <br /> work for which application is made and I comply with the Sfate Contractors La�v 18.27 RCW and <br /> 29G.2 0 WAC. <br /> �� , ' <br /> F � <br /> /D •%�- u5 <br /> ignature Date <br /> �GSro -G�► <br />