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ELECTRICAL PERMIT APPLICATIOiV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32C0 CEDAR STREET, EVERETT, WA 982p1 <br /> 425-257-8810 - FAX425-257-8857—www,everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM -DE81T&CREDI7 CARDS ARE NOT ACCEPTED <br /> /�l�e,^���/( �1�' <br /> �c; �-��° �1��1�; �c.� <br /> PROJECT ADDRESS <br /> <�C /V ' �-�L��� '' � � �7 � � �uP�� <br /> Ownef '� MailAddress ' CitY 1 Stale/Zip , �� ���, � <br /> hone <br /> �n'l� 19 � (;h-JLI '� <br /> Tenant MailAddrcss� Ciry StateZ <br /> P 1 Phone <br /> � -� � I�CtC� �C. � � ^ / /� / <br /> ��1, /r', ��� 1 �a /Ilci�itt 'Yt 7c�(��Y�7� 1 '�' ��"� l <br /> ElectncalContractor MeitAddress Ciy Slat . <br /> P Plw�e <br /> `�-,n� l,� �"4��y0�7 �/ �.�y <br /> Stale Licenso Number Contract Pdce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be�one: ` l.l�� �J(,I�'['�'1C S�7 Ll���� �,��t,n i <br /> —�� <br /> ��-c� �U� �j S� -�'� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF E4ERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/ylhat I have read and examined lhis application and know 7he same to be frue and <br /> correct. AJ!provisions o(laws and ordinances goveming fhrs lype ol werfc will be completed <br /> whether speciBed herein or noL The granting o/a permrf does not presuma to give autho�iry to <br /> peAorman enol consPrucfion nThat 1 amrauthonzed by fhe/o vne9o%ffh s properrty(o pe�o�m fhe <br /> work Ior which application is made and l comply with(he Slafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> J1:c�,� �, ✓1�G t-�z�.� 7 ((� ��cp <br /> SignaWre Dalo <br /> `n`, �7 .�-C� <br /> C . <br />