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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.4RE ACCEPTED FROM 8 AM TO 4 PM <br /> � , � `:^ -' ' ' r ,� .— _ �. • ��. "li <br /> PROJECT ADDRESS <br /> �-��� : , � ' i : � i . .n r��--1 <br /> Ownef M1tail Address City Slate2ip Phone <br /> 1 _J�-, l <br /> Tenanl Atail Address Cily State/Zip Phone <br /> .. >[__�; „- � �.-1 �� L � w �Q�=•r C-� 1._;c� `.n�.._ �`{L 2 -�'j_l 1-, ---;," � - �.' , - <br /> [lectrical Contraclor ' A4ail Adamss Cily Statel7_ip Pl,one <br /> _. ��� '= _ . ��C; =r <br /> . - r .�__..l "- 1i-1 l c'.F- � '�.. <br /> Slate License Number� Contract Price of Work <br /> n;�,,nced Use o(Building Contacl Person (Plan Review) <br /> I <br /> Description of Work lo Be Done: �-' �'. C �_� ' ��� �' �' �-'�� �' {- 4� —"� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. I <br /> J <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 hemby cer7ify thal l have read and examined this applicafion and know the same fo Ue irue and <br /> conecL All provisions ollaws anAordinances governing fhis type ol work�t�ill be complefeA <br /> ��hefher specilied herein ornot. The c�ranting o/a permd does not presume to give authonty to <br /> e�iolate or cancel the provisions o/any ofher sfa�e or local law regulaling construcfion or fhe <br /> perfonnance o/consfrucfion. 'fhaf I am aufhorized by the owner of fhis property to peifenn fhe <br /> a�ork lw which applicafion is made and I cornply�t�ith Ihe Sfate Contracfors Law 18.27 RCW and <br /> 29fi200 WAC. <br /> , . . �` l __ � . , - <br /> �, - - <br /> Slgnaturc Dale <br /> ���� ll� "G �� <br />