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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 —www.everettwa.org `� -',��4 `a S <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��J�l � . �r��r��' ���� U+���<l �'�� �-UC'_ It�h� � 6C� � ' / ��.� U � <br /> PROJECT ADDRESS <br /> %�li Y�� f�s�s ue ��� ��s �o ,�x 6�oqs �i�ioKELr� ��� QBi� o <br /> Owne� Mail Address City SWte2�p Phone <br /> Tenant Mail Address Cily State2ip Phone <br /> (�'o��nis�,� L/c��;��;�c � y,,,, �c��o� u.�A 98 U � 7 <br /> Eleclrical Conlraclor Mail Address Ciry StateiZip Phone <br /> ����v O <br /> State License Number Contract Price o(Work <br /> �=�.��s��n��G �5��ce � 1,��' �?lac�„T <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �Cf��������y �✓�� �' L �t C 7tiu C c-� ��o �, <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 31D5 <br /> 1 hereby certi(y thaf I have read and examined fhis application and kno�v fhe same fo be We and <br /> correcL All provisions o/laws and ordinances�overnmq tlus type oI wark will be completed <br /> �vhefher specil�ed herein or noL The granfing o/a permd does not presume to give aulhonty to <br /> violate or cancel the�rovisions o/any ofher state or local law regulatin�constn�c(ion or the <br /> pedo�mance ol consfrucfion. That 1 am aufhonzed by the owner o/Ihrs property fo perform fhe <br /> �vork/or�vhichapplicafion is made and 1 compty with the Sfate Confractors La�v 18.27 RCW and <br /> 296.200 W.4Q U <br /> �� �. [G%L( ,�— � .�� �f--- <br /> !/� � �J <br /> � Signature Date <br /> � � -�_ ( _ � <br />