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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 —�vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,� ^ <br /> "' �� 1 �/A� in Vi �Vi�� i/ <br /> �— <br /> PROJECT ADDRESS <br /> ' . � <br /> �7%�7 /vzsi��n �v'� �vs�c ,—� l� )� �fiL�i��i9�s�0 <br /> Owner Mail Address Citv StatelZip � <br /> �CJ7f9 � J�l'�`F�C[�A ) <br /> Tenant M� ��b� State�Zip Phone <br /> i 7A/S� �� <br /> : <br /> Cclrical Conhaclor hlail�ddioss City State�Zip Phonc <br /> Slate License Number Contract Price o(Work <br /> Proposed Use of Buildinq Conlacl Person (Plan Review) <br /> Description of Work to Be Done: � � c E �,�f�T/�/�G �£L �J �'���'�,l� <br /> .���,��?�� - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br /> I hereLy ceriif}�thaf l have read anAeeamined Ihis applicalien and knowlhe same to be frue anA <br /> correcL All provisions ollmvs and eniinances govemmg fhis lype o/wnik�vill be completeA <br /> whelher specilied hercin or noL The granling oI a pennd does not presume to give authority fo <br /> violafe or cancel fhe provisions o/anv ofher stale orlocalla�v regulating consfrucficn or the <br /> peAornrence c/construaion. Thal I,im aufhorized by Ihe owner o/Ihis property fo perfonn fhe <br /> work lor�vhich applicalion is rn;�dc and i comply with Ihe Stafr, Confiactws La�v 78 27 RCLV and <br /> 29&200 WAC. � <br /> �� si <br /> —c� .-�—_ _ <br /> SignaWre --, � Uatc <br /> �t,�10� 0�'� <br />