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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.evereltwa.org �( ..a <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��!Q�� � "�� <br /> � i ,; � �� /� , � <br /> , , � . � <br /> PROJECT ADDRESS <br /> O�vncr r.ta�i ndniess C��y, Si❑tc'Z�p �'��c��� <br /> li�__. <br /> Tenanl 1.1a�1 Aticlless Cily StaterZip Phone <br /> l-i � � _�� ;�L� �i ' 'i�� /i;,�r, � 1<111�� ��� rr/i� _ `/.'�; s�_ ��c.� <br /> EleCiric3l Conlraclor A1ml Address Clty State/Zip Phone <br /> � ._ . , , .:: J � _ - <br /> <�� I ;c��-F'� `-r `� =i f�;(., _ �� �� � ����"�" <br /> State License Number Contrect Price o(Work <br /> ('.'C � i 1`,( �.'�� , <br /> Proposed Use of Eiuilding Conlacl Person (Plan Review) <br /> p �l✓ � ' ,G ( <br /> Description of Work lo Be Done: (�' � �f" ��'(� '�C��/ � v �-` 1����i�'"�� C y i 1�( � <br /> L�� i <br /> ` 'C-1 rL —� '� $' C C <br /> � " i ' i i J--� � � � � i <br /> , NOTE: WIRING IN NON-DWELLINGS IS F�QUIRED TO FEE <br /> ii BE IN RACEWAI'S, �1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C, � <br /> 1 hereby ceitily thaf I hnve read and uxamined Ihis application and knou�Ihe sanie lo be 6ue and r�/,I I I v <br /> correcL All provisions o!laws and ordir��nces governuig this f}�pe oI�vork will Ge completed <br /> whefher speci6ed herein or noL The granling ol a pernut does not �resume fo gi�-e aufhority fo <br /> violale or cancel the provisions o(any ofher state or local faw regulaling constn�c6on or Ihe <br /> performance o/conslruc(ion. Thaf 1 arn aufhorizeAby the o�vner oflhis property to perlorm the <br /> �vork lor n-hicb application is made and I cempl}-u�ifh the Sfafe Coniractors Law 78.27 RCW and <br /> 29G200 WAC. <br /> �;-- <br /> . i �' . . . �-� <br /> � <br /> �SipnNlure U0�0 <br /> . ._ . _-_ -____ ____'_-_— <br />