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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEkiVIIT 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 G��U—D� <br /> C 1�� <br /> �1 g <br /> �J�� r'nT14--INL 1Li �'^� �f,�JC UN�T C, <br /> PROJECT ADDRESS <br /> L� i�c ��tir� U�>�,c� <br /> Owner Mail Address Cily State/Zip Phone <br /> Tenanl M.il Address Cily Slate�Zip Phone <br /> ��2S �y�� '��S 1 <br /> '� irnr�'�1T C� e- ���"uc � 2,03 ��,l��t- Si rv� S'f11N�o�� wA ;n�'�-`'- <br /> Eleclrical Conlraclor A�ail Address City State2ip Phone <br /> ��� rnr� 1C I �� �L� <br /> .o:,., <br /> Slale License Number Contraci Price of Work <br /> � S�l� <br /> Proposed Use oF Building Conlacl Person (Plan Review) <br /> Descriplion o(Work ta Be Done: l�i � �)C � J'r F_ U--v I�Mr �CG-V'� <br /> NOTE: WIRI;�G IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IiJ RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily fhat I have read and exarnined fhis app'icafion and kno�v the same to be Uue and <br /> cunect. All provisions ellaws and orclinances govem,ng this type oI�rork will be complefed <br /> �vhefher speci6ed herein or noL The granfin�oI a�ereirt does not presume fo give authonty fo <br /> violafe or cancel the provisions o(any o(her state oi loce!law regulafing consfruction or the <br /> pmformance o/constiuction. Thaf 1 am authonzed by fhe owner o/fhis property to peAonn the <br /> �rork lor which application is made and I compty wifh fhe Stata Contrac(ors Law 18.27 RC W and <br /> 296.200 WAC. <br /> � -� � -------- 6 - ' �I • v c� <br /> Signature Dale <br /> ��D�/A➢'�C�� <br />