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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wuvw.everettwa.org �`�-3 _�O <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��Qfj7—d�`�' <br /> ��t/� //�� �r�;ll (',� �� �W i <br /> PROJECT ADDRESS <br /> �n�q � No(�i�� L,LC/�Z3(b �o"'��'E�G�o�lnl ln/A�� �021 <br /> pyy�gT MailAddress ' City State/Zip Phone <br /> Znf�c.. 19/v �url/l (1r� f�y- £✓cr� lJ.� I802/_ <br /> Tenant Mail Address Ciry State2ip Phone <br /> ���� �F�,�;�, ��� ��� C� i���h,� F .� f�.� c� q�ros �� �`��.�� yy <br /> Eleclrical Conlractor Mail Address Ciry StatelZ�p Phone <br /> E��F�C��L�I�j � �-- lSoO . <br /> Stale License Number Conlract Price of Work <br /> ��i7/� �d'R��• <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description ot Work to Be Done: � �'k�� '���f�L' `l����'U s�"�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �./; <br /> 1 hereby ceRily fhaf 1 have read and examined this application and know fhe same to be true and � /y iy, <br /> conect. All provisions o(laws and ordinances goveming this type o(work will be completed �(fV� <br /> whether speci(ed herein or nof. The granting of a permit does not resume fo give authonty to <br /> violafe or cancel the provisions of any ofher stafe or local law reguPting construction or the / •) D <br /> performance o/construction. Thaf 1 am authorized by the owner of this property to perform the I/ <br /> work/or wbich application is ade and!comply with t e Sfafe Contractors Law 18.27 RCW and (� <br /> 296.200 WAC. <br /> - — rv <br /> Signa Date <br />