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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PE.-^.�UIIT SERVICES <br /> 3200 CEDAR STREET, ��ERETT, WA 98201 1D —ly`�� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � <br /> ` 6 �'io-� �9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �d�j �j V"l�`�'1 rv� av� <br /> PROJECT ADDRESS <br /> s� �o r-� <br /> Otvne� Mail Address Cily Statz!Zip Phone <br /> Tenanl Mail Adtlress City SlatelZip Phone <br /> ��,,-�s �/��. 73� �`��. ,�f� cJ s,�,>��,��/� �'��� <br /> Electrical Contraclor Mail Address Ciry State/Zi Phone <br /> � � <br /> l_I--C1 rF— C �[ � / f\ � ` ��C/l/� <br /> Slate License Number Contracl Price of Work <br /> /V��� ��7v <br /> Proposed Use o(Building Conlact Person (Plan Review) <br /> Descriplion of Work lo Be Dane: /�Dv �/ ���" ��% �"2� �� � C� <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 :5 3105 — � <br /> =� � .';.--,1 �i L. ��- `� <br /> 1 hereby ce�iily Ihaf 1 have read a^d examined fhis applicafion and kno�v the same to be lrue and � -- <br /> conecl. All provisions ollaws and ordinances c�overmnp Ih�s type o!n•orl� will be cornplefed ' <br /> �ahelher S� died herein ai noL Thc gr��ntinc�o(a pernut doe5 nof resume to give authoriry ro <br /> violate of can I the provisions o(any other sfafe or local law reguPtinc�consfn�ction or fhe <br /> perforrnanc�consiruction. That 1 am aufh iz by the owner oI this property to pedorm Ute <br /> �vork lo�which� plicalion s made ati 1 c .i I � ifh the Sfate Contractors La�v 18.27 RCW and <br /> 29�.20�\WAC. / <br /> ,� /� / -��� <br /> Signaturc Uate <br />