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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � y� �... M r-_� v, �.t �3v� �A <br /> PROJECT ADDRESS <br /> � 0 u �.J �� I.1 � ,L vJ C.'i, s�: �r. i�l. 1 �d2 S L L L <br /> Owner Mail Address City SWte/Zip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> i�i � C� ,I,�TV ��L�S�i (, <br /> Electrical Conirector Mail Address C��y State�Zip Phone <br /> ;�� � v , �,� CcoO � NT <br /> State License Number Contract Price of Work <br /> SFI: <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work fo Be Done: C:) I R I� 7v�W S}—� Z d� �'N)� (,� - �,. <br /> NOTE: WIRING IN NON-DW[LLINGS IS R[�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� 0� <br /> CITY OF EVERETT LOCAL SALES TRX CODE IS 3105 <br /> I hereby ceriity thaf I have reaAand examined fhis applicafion and know fhe same to 6e We and <br /> correcL All provisions o(Imvs and ordinances c�overning fhis fype ol work will be compfeted <br /> whether specilieA herein or noL The gran(ing o!a perrnd does not rosume ro give aulhonty to <br /> violafe er cancel the provisions oI any ofher sfate or local law reguPting conslrucfion or the <br /> perlormance olcons(rucfion. That I anr au(horized 6y fhe owner ol this properiy to peAonn!he <br /> k�ork lor which applicafion is made and 1 cornply wilh fhe Sfafe Contractors Law 18.27 RCW and <br /> 29�,200 WAC. <br /> � �/� ,, � 7 . //- b�� <br /> < Si natwe Date <br /> � ��,o ;- �� <br />