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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8.9M TO 4 PM <br /> ti% i'Lt�i/� _i7� �f�i,>�E�/� <br /> PROJECT ADDRESS �- ,/ <br /> �`.�S J��D • 7�.2'�� <br /> i�,c9��� � J� `' S`' `� � C' �.�,:�; _ <br /> �°P �'��0 7JQ��:.,st� ,�e ����n �,� � ,�SL A <br /> Owner Mail Address Ciry Slate/Zip Phune <br /> Tenanl Mail Address City State2ip Phone <br /> /I��.C/a�:G'i L! ' � C�� • /✓�'� J .S�'=`JA��'t.� �� �na�f l.q �'i����� �11����'7/G� <br /> ElectriCa�Conlr ..lor Mail Address Ciry Sta1e/Zip Phone <br /> ��(°'� � /Ji= %� '�.i�� ,3�'�a ��"' <br /> State License Nmnber Contrecl Price of Work <br /> �l, - ,, f /�n f 1 /� � i.�-:c', <br /> Proposed Use of wlding Contact Person (P�an Revie <br /> Descriplion of Work l0 6e Done: f�/�� � L �� •i� /�O / 9T��H <br /> NOTE: WIRING IN IvON-DWELLINGS IS REDUIRED TO FEE <br /> � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf 1 have read and examined Ihis applicafion and know the same to be We and <br /> correcf. A!1 provisions ollaws and ordinances govemmg 2his type o/work will be completed <br /> whefher specdied herein or not The granting ol a permit does nof presimre to give aulhonty to <br /> violafe or cancel lhe provisions of any ofher sfa(e or local law regulafing consWction or the <br /> perlonnance ol construcfion. That 1 am aufhorized Uy fhe owner o(Ihis property fo peAonn fhe <br /> �vork/or which applicafion is made and 1 comply wifh tlie Sfafe Contractors Law 18.27 RCW and r'�� <br /> 29&200 WAC. <br /> � /� / � <br /> i ;�� �D. � � �� �� � �� -� �, � � )��� <br /> SignaWre Date � <br />