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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 Q - FAX 425-257-8857 —www•everettwa.org g- u�'��.� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> [_o s���-o y�� <br /> ���1 �z't'Fi�'l u-�2 t v�.�t.��' o�i�1.J�� <br /> PROJECT ADDRESS <br /> `," " � 51� �, /S`� L �(I, lr'/� ���L1oG� <br /> �tLC���I'/`flr ti�����iC�i �� ��tL « Jr .�T Phone <br /> Owne� Mail Address City State2ip <br /> Tenanl <br /> R1ail Address Ciry StatelZip Phone <br /> �,L'�M ���cn« ((�`cti{ �h,o�c; P� ���D �r�(1 l�li �lL�.�Nhn.1 �-� �1�5'1-L) <br /> [leclrical Conlractor <br /> htail Addmss City State/Zip Phone <br /> C nl'r ,��0`��� <br /> ULl�� �L 1G�i � <br /> Slate License Nwnber Contract Price of Work <br /> Proposed Use of Ouilding Conlact Person (Plan Review) <br /> —�,�p Sc2�,<< -- <br /> Descriplion o(Work to Be Done: <br /> � <br /> i O <br /> ( � <br /> NOTE: W!RING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAR CODE IS 3105 <br /> I heieby certily that I have read and examined this applicafion and know fhe same to be Vue and <br /> correct All provisions u/laws and ordinances governing this type o��•vark�vill Ue completed <br /> �vhelherspeci6ed herem or,noL 7he c�ranfing ol a Uernut dues nof presume to give aufhority lo <br /> ��iolafe or cancel the provisions ol any ofher state o�local law regulahng construc6on or the <br /> pr,dorrn,�nce o�construcfion. Tbaf f arn aufho�ized.by the owner of IYis property fo peifomi the <br /> a�ork!or lrhich application is made and 1 comply wdh the Sfate Con6ucfors Law 18.27 RCW and � <br /> 29f.200,Y✓AC. � <br /> _���� �`��� �U� <br /> �Signalure Date fii <br /> J <br />