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ELECTRIGAL PERMIT APPLIGATION <br /> C17Y OF EVERETT PERMIT SERVICES a � -�-o S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 O �O a `(�3Z <br /> 425-257-8810 - FAX 425-257-8857 -www.everethva.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> � <br /> � � <br /> `% �7 � '�'_('- _� � ! �l,iJ � j�Cj C'_, <br /> PROJECT ADDRESS � yL�-:��� <br /> t' l /Yr <br /> � 1� � ���� ��l , <br /> ;,�;.��: i) � ( I �)(� lC•-� ��� `� C l ;i���t"r(� ���1`� _�1 TGc'Ar` Tf ��- � � / <br /> Owne� Mail Address City State2ip P�one <br /> Tenant Mail Address City State2ip Phone <br /> �� <br /> _ ,� <br /> '`/.r� �f� I '� ' � � L�N �,;..:;c: � , 1L '1 j`���'�� �ZS'7�� �' »�" <br /> �_ �\�lL � �-1 l I/L� HT'..���� �t".�T(�J� �C � �c y <br /> EleCtrical CoMrettor hlail Address City State2ip Phone <br /> ( l�lt�l �- 1-���r'0 �°�1� � �� 4' / `=: <br /> State License Number Contract Price of Work <br /> j �i�%N '� ��cN � �i (il ��.�� � ���( � ' � iZ � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> i <br /> , Description of Work to Be Oone: 1—� (�� K���`' ti� �'��',< < �'�L r l/1 r�_> y ('//i C�. //��S <br /> h��dC� ' ( '1/��'lt (T'_? . <br /> , NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> �I BE IN RACEWAYS, MC OR AC CABLE. <br /> � GTY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I I hereby ceRi(y that 1 have read and exam�ned this applicafion and know the same to be We and <br /> �' correcL All provisions ol laws and ordinances govemmg lhis type oI work will be completed <br /> I �vh,e�her speciGed herem or not The granting c/a permd ooes not presume to give authonty to <br /> � wolate or cancel the provisions of any other sfate orlocal law regulating construction or fhe <br /> peAormance ol construction. Thaf 1 am authonzed by the uwner e/this propeKy to peAorm the <br /> �I �verk la which application is�made and.l comply wifh the State Contracfors Law 98.27 RCW and � <br /> 296 200 WAC. . � f . �� �7 L/ <br /> � .� �, . I � - ii - 7 <br /> �:' � 1 � C�' .� C�%� �. �� � / ` 5 ; �'�' � <br /> ��, - Signature � Date / ) <br /> lil � <br />