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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 - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � I <br /> � � -, ' i . . <br /> � <br /> � i , <br /> �\` �. i�. � c �.le I l.�C,�_ <br /> PROJECT ADDRESS <br /> � ' � � <br /> �' : � _ -I " � % <br /> � ' i � i � ( " �" I I Y ..� �i C � .� G( � <br /> �_ ; lY:����.� 1 /� � � i 1� �i i � � � I I � � . , . . �f� ' � <br /> r <br /> Cil Slate2ip Phone <br /> Ownur Mail Address y � r � � <br /> �i � :("� � l( i. <br /> SintelZip Phone <br /> Tenant Mail nddress City - <br /> ��� - <br /> �_ � �� ��� �.�{. 1�`�eiC��.��z� ,�.� `-j���< �> >C��.iT� � <br /> _A��„�,��,�-C��� �h:�c.k�:�,,��_ '!i' l �"�`��! ) e- — <br /> Cit SIa1cIZip Phone <br /> [leclncal Conlractor Mail Addmss ' Y <br /> � , ���- "> �'r:�t <br /> Contract Price of Work <br /> Slale LiCense Numbei <br /> / ( � � ( � , l.i � ( <br /> Proposed Use ofBuilding, � Contact Person (Plan Review) <br /> � ; i r� �. :- " � . <br /> I • I � I 4_L ;�_ <br /> -'�(�_��� ( I�L ,.c� ll. � ':Lil:: � <br /> Descriplion of Work to[3e Done�. �.I , <br /> NOT[: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. i '�� �,'� — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceridy fhat I have read and evanuned(his a�,pOcafion and kno�v fhe same to be Lve and <br /> conect All provisions olla�vs and ordmances governing Ihis fype ot�•.ark�vill be cornpieteA <br /> �vhef0er tuecdied heiein or not. Thc grantu�g of a permR does nol resunle to yive aulhonty to <br /> violate ar cancel fho proasions o!any ofher state or loc�l Imv reguPling consLucLon or fhe <br /> pedorrnmice o!construction. 71rof I am authorized by Ihe o�vne�o(this property to pedarm the <br /> �vork for�vluch applicalion is made and I cornpty willi Ihe Stafe Confractors La�v 78.27 RCW and <br /> 296200 WAC. <br /> , <br /> i <br /> � �• ' ��i �' , i l <br /> i <br /> � i.(- ` �"Y u l(_t,..�� �; - ' � � <br /> r � I��� � �ale <br /> SignaWre <br /> �=a5�u ��o( G <br />