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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8010 - FAX 425-257-8857 —www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ! ��� '�e�r� ► � c��� P��y <br /> PROJECT ADDRESS <br /> �, ��, -� i� O -2 L�J <br /> Owne� A1ai1 Address Cdy SIa1=2ip P one <br /> �T� �ma_.-�a--� <br /> Tenant M11ail Address C�ly Slate�Zip Phone <br /> }�Pa rY'� i�i1 (�(��YL� I Z 21 2r�d tiv� n I�i�,W�- <br /> Eleclrical Contractor Mail Addres C�ty State.�Z�p hone <br /> I���n�c�,�� Gq� D�� _ ��60C� <br /> State License Number ConVact Price of Work <br /> � �1 e i <br /> Proposed Use ol8vilding Co act Person (Plan Review) <br /> Description of Work to Be Done: I� ,I�-�� I ��w � �� "'+�' <br /> I"2 �� (`C,L,+ Z -� -S���S <br /> I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily th�t 1 have read and exarnined fhis applicaticn and know Ihe same to be We and <br /> correct. All provis�ons o/laws and ordinances governmg fhis type of work will be complefed <br /> whether speci/ied herein or not The granGng ol a pennd does no(presume lo give authority fo <br /> violate or cancel the provisions o!any ofher sfate or local law regulating construc6on or the <br /> perlorma o/consfruc6on. That 1 am authonzed 6y the owner olfhis propeMy fo perform the <br /> work lor vh h application is made and!comply with the Sfafe Contractors Law 18.27 RCW and <br /> 296.20 W C. <br /> —.� � q 2� G <br /> Si nature Date <br /> � �i . <br /> / .'`� — C. <br />