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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 —wnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1�i �'1�f�,�i �o�/��� , R����i� <br /> PROJECT ADDRESS � <br /> h�.�ls� y-��,-��t�.� <br /> � /� (,� (� � <br /> /`f� n �� J `�JG �r/1�'�i�rs•��. �N2 J��',�nd J.4J ,/Ji� , A ,�1i I <br /> Owne� Mail Adtlress Cily lale2ip Phone <br /> Tenanl Mail Address City Stale2ip Phone <br /> �S��• �i�,�, <br /> .�1��� ��„- i-��?.,�a�=�.9��r cJ ��,���Js /�la �if�e�[� <br /> Electrical Conlra or Mail Address City Slate/Zip Phone <br /> �r=/D `I� � �S`'� OS'S� �� <br /> State License Num6er Conlract Price of 1Nork <br /> i1 - (�dJ � ��� A < <� ,��,- <br /> Proposed Use of Buildin Contact Person (Plan Rev' w) <br /> Description of Work lo Be Done: � �� � � '�J�n� ✓���P <br /> i <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 IS 3105 <br /> 1 bereby cerlify thaf 1 have read and examined fhis applicafion and know fhe same to be true and <br /> correcf. All pro�as�ons ollaws and ordinances goveming fhis type ol work will be complefed <br /> whefher specilied herein ornot. The granting o/a permd does not presume fo give authonty fo <br /> violale or cancel Ihe provisions of any other stafe or local law regulafing consfruct�on or fhe <br /> performance o/construcfion. Thal I am aufhonzed by tlie owner o/fhis property to peAomi fhe � <br /> work Ior which application is made and 1 comply wifh the Sfate Confracfors Law 18.27 RCW and � <br /> 296.200 WAC. I <br /> 1 i <br /> � YC `� , - �- oG� � f1, <br /> Signature Dale �� ' <br />