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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 425-257-8057 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,�% "� �=" `;'Y1a �„�P c.�� e� �.� 1��_ �T� �/.a y�_�i <br /> CUCV� ( <br /> PROJEC7 ADDRESS <br /> l�, h LL�u �, n -. l- �ti -; - _ �/zs �5z Yv_�/ <br /> Owne� Atail Address City Stale/Zip Phone <br /> Ji . ___ <br /> Tenant ktail Address Cily Stale/Zip Phone <br /> L �� � v�� cc• (� C�eCT`��C �S/� �i'1'f('pU l�� ��U'c� C<<-��iv_5C. Cc lti-%�`=`7e'� jECy�iYOPe�/ <br /> Eleclrical Conlraclor Mail Address �ly State2ip Phone <br /> ���,�d ; <br /> < � � � �v���s-�e�zz6-'F � ,�/:SGo ��� <br /> State License Number Con�ract Price o(Work <br /> �J�-;�ca��,.,��._ C <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work to Be Donc: L��� C,t <� c�e -`��' o- �'�c� ! �- ��CC1 l� w� i?5 C71 %(' 1/' G1='�f+ <br />\ NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read and examined fhis application and know the same to be true and <br /> conecf. A/l provisions ollaws and ordinances govemmg Ihis type oI�vork will be contplefed <br /> whefher specdied herein onwL The c�ranting o/a pennd Aoes not reswne to give auUionty fo <br /> violate or cancel the I�rovisions oI any other sfate or local law reguPfing consfruction or fhe <br /> perfonnance o/cons(ruction. That I arn aufhorized by the owner o/th�s property to perlorm the <br /> �vork!or�vhich applicafion is made and I cornply�vilh the Sfate ConVactors Law 18.27 RCW and <br /> 296.200 WAC. <br /> L `j`Z_ G� `�` <br /> j�c's��(-7 ��Vlc• _�^-� �- <br /> Sighature Dale <br /> j'�j�(-IS� <br />