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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CCDAR 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 /> ��oi �J���,,� �,.��.�� /�i�� �-� <br /> PROJECT ADDRESS �� � <br /> i'�,��y;�°� /��v/ �/l��`f�y��� ��� �l�v 9,�0 3(� ��s��0 1,��� <br /> Owner Mail Address City Slate2ip Phone <br /> Tenant Mail Address City State2ip Phone <br /> cl�>� -�,��,,�. ,r���� _ i�36 .s' .�a�-�i��� � �,�,�>».����a� ��s'9-��-�r�� <br /> Eledrical Conlracto' Mail Address City State/Zip Phone <br /> ) . � ���� �/7 .� � �OC = <br /> State License Number Conlract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Ba Done: r�n,, �J!�' <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 /> I hereby ceriily that 1 have read and examined Ihis application and know the same lo be fn�e and <br /> conect All provisions ollaws and ordinances governmg fhis type o/work�vill be comp/efed <br /> whefher speciGed herein or noL The granfing o/a pernaf does not resume to give aufhonty to <br /> violate or cancel fhe provisions o/anv other sfate a local law reguPting construclion or Ihe <br /> peAormance olconsfruction. That I arn aufhonzed by fhe ownero/fhis property to pedomi fhe <br /> work lor which applrcation is made and I comp�y with the Sfate Contractors Law 1827 RCW and <br /> 29G. 00 WAC. � <br /> j � <br /> �%' ' '�` ia i�%� S <br /> Si ature Date <br /> � 05/D � <br />