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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88I0 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � � .� 7� -����� � �'L `� � <br /> PROJECT ADDRESS <br /> � � !� �1-v� C . <br /> Owner Mail Address City State2ip Phone <br /> Tenanl A9ail Address Cily Stale/Zip Phonc <br /> (i1}5� <br /> �1ik ����� �� �rc1�ti� =l-�,c. :;�:���E G ��� � � Iv-G. i"1G�Hs�.11�', «'�i `is.»G x��:�i <br /> EleclriCal Contrat�or Mail Address City Stale/Zip Phone <br /> V� ��.1.�V Y-7 �),�C�� <br /> Slale License Number Conlracl Price of Work <br /> ,--� ill���� "\Z1�.�,�4 Y�VI� � �l+�ri <br /> Proposed Use o(Duildint� Conlact Person (Plan Review) <br /> DescriplionofWorklo�eDono: � ' � +"'�1C�(�� ��Jl\���i���GWP�� �C��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily thnf I have rend anJ examined fhis applicafion and Wiav fhe sarne to be frue and <br /> correcL All provisions of laws and ordinances�oveming this type oI work u�ill be complefed <br /> whether specdied herein or noL Thc granting o/a pernut does nof presurne fo give airtbority fo <br /> violafe or cancel the provisions o�any other sfate or local law rec�ulafin[�constn�ction or fhe <br /> peAonnance ol consirucfion. That I am aulho�ized by the rnvner o/this property to perfomi fhe <br /> �ti�ork!or which applicafion is nu.de and 1 cornpty wifh the Sfafe Conf�actors Law 78.27 RCW and <br /> 296.200 WAC. <br /> -�_� T�-- �/�v%n� <br /> __ ' Sic�nal�e Dale <br /> � <br /> �,�� 1 � 2= <br />