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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.everetiwa.org <br /> APPLIC �TIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � .: V �Y. L^� L,i, r_r �c^;rl S �. !'C�J �Cl/ / S Q <br /> v <br /> PROJECT ADDRESS <br /> � f )� � <br /> �:G-C�1 Y` .�-%/'�C �' �'i" it � <br /> Owner � 61ai1 Address Gty State�Z;p Phone <br /> Tenanl Mail Address City StataZip Phone <br /> /L`(' ,�'��cr/'i .0 1-l.L7 f, �'t'.T�-/[� <br /> EleClrical Conlratlor " Mail Address City State/Zip Phone <br /> State License Number Contract Pnce of Work <br /> Proposed Use of Building Contact Person (P!an Review) <br /> Description of Wark to Be Dane: G�l .f-r. f✓�-W j�� ,�� ` <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL BALES TAX COOE I;3105 <br /> � I hereby certify that I have read anA examined this applicatien and know the same to be true and <br /> Ir,orrect. All provisions ollaws and ordinances govemmg ihis type of work will6e cempleted <br /> wnether speci6ed herem or not. The granling o/a permd dces nct presume to give authonty to <br /> viclate or cancel the pmvisions c(any other state er local law regulafing construcfion or fhe <br /> Ioedormance o/construcLon. That 1 am authonzed by the owner o/this property to peAonn the <br /> ��vak Icr which application is made and I compty wdh the State Contracters Law 98.27 RCW and <br /> 2a6.200 WAC. <br /> � �l-�_�__ d / �/�� / i <br /> —�S g awre / Oare���— �� <br /> I <br /> � ` �� � - I � � I <br />