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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRGET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www everettwa.org <br /> APPLICATIONS ARE ACCEPTED rROM 8 AM TO 4 PM <br /> ��G�� ��i cl (-�-V�1� :j r- <br /> PROJECT ADDRESS <br /> ��� � - <br /> �' i �� r� - <br /> Owner Mail Address City Slate'Zip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �LI)`�� <br /> �' I IC 1 NC"� ��P ca-r,� ,i�,c �S+�.X� �J s i i�k'. N•f-. ��nc�� .,s�.;�(� �o . �i g�� `�% , � <br /> �-c� c <br /> Elecirical Conlraclor Mail Address City SWtelZip Phone <br /> \� 7 k�' N �7 `!�_�-� � <br /> Stale License Number Conlracl Price of Work <br /> Proposed Use of Building Cuntacl Person (Plan Review) <br /> I <br /> Description of Work l0 6e Done: -C' =�i� ��C�.�i G�\1� ���Cr j�r✓�,p p .V)�;r'��� �� �c:��p <br /> � <br /> i�. i��-� ',.. .c���,—}.. ' <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�fl/y thaf 1 have r�ad and eA;�mined tliis applicafion and know fhe same fo be true and <br /> correcL All pmvisions ollaws anA ordinanr.es governmg fhis type ol work will be canpleled <br /> n�hether soeciGed herein or noL The granfing of a permrt Aoes nof uesume fo give aufhonty fo <br /> violale or cancel fhe p�avisions ol an}�olher sfate o� local law regc�afing consfrucfion or Ihe <br /> peilonnance of construcfion. Thaf I am authorized 6y Ihe owner o!this property fo perfonn the <br /> woik lor which applicafion is made and 1 comply wifH fhe Stafe Conlractors La�r 1827 RCIN and <br /> 29b'.2��WA�. <br /> _ �• rJ � `����-/G� ,, <br /> SignaWre f'ate <br /> �U , /��, <br />