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i <br /> 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 /> %�o/ >�i�,� ;// C�,� �',�/w,, �/��� �� <br /> PROJECT ADDRESS C� <br /> _,,�� f lC'l Y�l��' jO ��S � <br /> Owner Mail Address Cily State2ip Phone <br /> Tenani Mail Address Cily State2ip Phone <br /> /// �/l/i U/�: ' i�LC,,c�!• /�.'�L)i •y 7("����c'E CU i�'lYIC.�XI�' 7J O�G 7i'l9'/7r�'�/(. <br /> Eleclrical Conlrac r Mail Address Cily State2ip Phone <br /> �j ✓ / ,.4 <br /> /77L M1 .�1� r' ✓/� � � CO / ��� <br /> State License Number Conlract Price of Work <br /> Proposed Usc of Building Contacl Person (Plan Review) <br /> Description o(Worl:to Be Done: a"DD �im a ���'��cJe"2 /oL f' <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y ihaf 1 have read and examined this application and know fhe same fo be frue and <br /> correcL All provisions o/laws and ordinances goveming fhis type o/�+rork will be completed <br /> whefher speci6ed herein or noL The granfing o(a permif does nof resume fo give authonty lo <br /> violafe or canc�, the provisions ol any other sfate or local law reguPfing consfnidion or the <br /> perforrnance ol construcfion. That 1 arn aufhonred by the owner of this property fo perforrn fhe <br /> work lor which applicafion is made and 1 comply wifh the Sfate ConV�cfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �/''��,L� �11'I�` � ; �2 /- D � <br /> Sign ture Date <br /> �0100?-oG� <br />