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ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-6810 - FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��3 ��<Y t,�r �!` l=vef'�N Wu• 4 S(�d3 <br /> PROJECT ADDRESS <br /> / , <br /> `' >ii/.'C�'�l L l � ��i��� C /h�G;� %�<ie-cvz�. �v✓ °�.�� Lc/i' /�(� 5�a�`%s�i� <br /> � ��, Stete2ip Phor.e <br /> Owner Mail Addfess <br /> S 5 � SLi....L � <br /> �• e �m, Stata2ip Phone <br /> Tenant Mail Address <br /> � v t,U r�.e � <br /> Electrical Contrador <br /> MailAddress CAy StatelZip Pho�e <br /> �//�! /V � <br /> Stete Li nse Number <br /> Contrad Price of Work <br /> S � ° � � G"'""' � 1 Contact Person (Plan Review) <br /> p�p�e of Buildi�g <br /> Description of Work to Be Done: � /'! G �Ct r I' �',n� � /+�� ��� S � �n <br /> NOTE: WIRING IN NON-DWELiINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COCE IS 3105 <br /> conecfy All pr�ov�sions o�laws and o dinanceds govemPng fh s type o%work wfll�comp ej feNdB and <br /> whefherspecified herein or not. Trie granfing o/u pertnit does nof piasume to grve authority to <br /> violafe or cancel the provisions ol any ofher state orlocal law regulafing conshu�n���the <br /> peAormance o/construcNon. That 1 am authonzed by the owner o/this pro�W 18�7 RClNand <br /> work/or which applicafion is made and 1 comply wifh the Stafe Contracfors � <br /> 296.200 WAC. <br /> . � �o /� (� ��r � �l <br /> . ,'; � .L�,�L,uJ � � l/'t-�-'' / <br /> Signature Da <br />