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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _ p y _��� <br /> (=O�C I -�'�'� <br /> ' 3 -3 I��c�� � ��i E- r- !� �'; ✓c' <br /> PROJECT ADDRESS <br /> S I�T ��"c�I�E- t�^l �f `� <br /> OWnef Mail Address City State'Zip Pncne <br /> Tenant A1ail Address City State/Zip Phone � <br /> �fZS <br /> {'� �(��c-� rlc 3`'-a2 ��f�, sc F���'�-�-t- wk �/�'z° �" �'�� s3� <br /> Electrical Conlraclor A1ail P.ddress Cily StatelZip Phone <br /> � �`" �L ( �_. `'/ 3 �� k (' �o��� �--� <br /> State License Number Contracl Price o(Work <br /> Proposed Use o( Buiiding Conlact Person (Plan Review) <br /> Descriplion of Work 10 8e D�,ne: (,'J� ��— � c��b S�� I U���1 �Jli( �_ <br /> C <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 /> 1 hereby certily fhat 1 have read and examined Ihis epplication and kno�v the same fo be true and <br /> conecL All piovisiau ol Imvs and ordinances�overning fliis type ol�vork will be completed <br /> �•�helher specified herein or noL The granling o(a pennd does not resume lo give authonfy to <br /> violafe or cancel Ihe provisions o/any ofher stat�or local/a�v reguPfing consfrucfion or the <br /> peilonnance oI c.msfrucfa�. Thaf I am aufhorized by the owner ol fhis properly to perfom�the <br /> work lor�vhich applicaf�f is made and 1 comply with the State Confracfors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> � <br /> ����'------ � ,_ �_ c,�— <br /> SigrSa Date <br /> 't'O$G 1 -GC,� <br />