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ELECTRICAL PERMIT APPLICATION <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, WA 98201 <br /> 425-257-Fi810 - FAX 425-257-8857 - �vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � �� � 0 �l�-L�� E (� -('�(� � l�' L � �.'<` r" �t� ��7 cr . t �Z O � <br /> PROJECT ADDRESS <br /> I'���—�� `}�--''f 1/IIlC"Ir I `=>Z -1 1z �� CKcF-tll ,-�� 1��2� .�-�-r �.�'�;� � �Zi% I <br /> Owner I / Mail Address City Stale/Zip Phone <br /> /� ��- <br /> Tenant Mail Address City State/Zip Phone <br /> /V l/fl <br /> Eleclrical Contractor htail Address Cily Stale2ip Phene <br /> .� /�=1� _ �� � � <br /> Slate License Number Conlract Price ol Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> �_ f <br /> Descriplion of Work to De Done: �'�-� 1)�'.� �,1 .-A -/1�����'� <br /> V ' <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhal I have read and examined fhis application and kno�v the same to be true and <br /> correcL All provisions o(la�vs and ordinances goveming fhis type o(�rork�riil be cornplefed <br /> whefher speciGed herein ornoL The granfinq o/a pernuf does nof preswne!o give authonfy fo <br /> viola(e or cancel the provisiCns ol any ofher stafe or local/a�v regulating construction or fhe <br /> `peAomiance o/cons(ruction Thof I am authonzed by the owner e/fhis property to perfomi the <br /> tror -for�vhic applicalion is iade and 1 cornp/y�riNi the Sfate Contractors Law 18.27 RCW and <br /> 29G�20�'l�A�. <br /> �� � !�_ -' 1 Z � z- � ��� � <br /> Signature Oate <br /> �oc� I � - I i � <br />