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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FP.X 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � c, _ p � <br /> �f� C- 6`8al-Dil <br /> �� � lf- l �-Cr( rl (F 4' UJY"-I �� _ <br /> PROJECT ADDRESS <br /> I <br /> � �� •� l�� _ � ��C ✓�"IF `� <br /> Owner Mail AddT_ ress — City StatelZip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �? S <br /> �J � -c� --i�I � 32�2 r ��'r� S�- �J�(e��i ��2� � �'�o �3d� d <br /> Eleclrical Conlrector Mail Address City State2�p Phone <br /> �d���l "r= �_ `j � � I� � �o o � �—__ <br /> S'late License Number CoNract Price o(Work <br /> Propused Use ot F3uildin9 Conlacl Person (Plan Review) <br /> Descriplion o(Work l0 6c Done' �-�� � ���� � �v O �� �v�������1 1 �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�tily that I have read and examined(his applicaliun and kno�v(he sarne to 6e true and <br /> � correcl. All provisions o//a�vs and ordinances govemrng this type of work uill6e complefed <br /> tvhether spea6ed herein or noL The granling ol a pernut Aoes nof presume fo give authority to <br /> violate or cancel fhe provisions o/any other stafe or locaf law regtdating construc6on or the <br /> perforrnance of conslrucfi . Thal l am aulhorized G}�Ihe o�vner o/this property(o perfom�fhe <br /> work lu�which applicatio is�nade and 1 compty�vith fhe Stafe Contracfors Law 78.27 RCl^�and <br /> 296200 WAC. � <br /> �/�G�j� � /��_-��'��—' <br /> Signa e Date <br /> %-�f� o� <br /> � �-goi -V � I <br />