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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 7�, i=; �':��_���.�:r- h� _ <br /> PROJECT ADDRESS <br /> �i.. . l - . `� . , i,,.� -�-l` F_ /�S._"L' It � flp �-r�L� 1.{ � l I�1,7 .� �(- �' <br /> 1 __�_ <br /> O.vncr 1.!ail Addross �City S�aIe21p Phone <br /> Tonanl .____ . P.1ailAddic::; �—_—_— Cily Jlate2iP Phenr. <br /> �t�,4��t,. E4,<��c .._ �I�„=_ 2� 3c /{.a� ... ; �v_t�•,t-t� �L� `i�2�3 �-1?�S-�id . 7C:3 <br /> Eleclrical Coniraclor Mail�ddress Ciry State'Zip Phone <br /> ��z,FC i 95s? CN 7•So cc <br /> State License Number Contract Pnce of Work <br /> � . �, l� — <br /> Proposed Use of Building Contact Person (Plan Revicw) <br /> Description of Work to Be Done: �S� � ���J b` G:��,"c - �1 ��T'c� {�'-�F '�c��q <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�lily fha(1 have read and examined fhis applicafion and kno�v Ihe same to be frue and <br /> coirecL All piovisions ollaws anAordinances_qovernmg fhis type o/worh will be cornpleted <br /> whMher specdied hercin or not The granting o/a pernuf does nof presume to give awhonry fo <br /> violale or cancel Ihe provisions ol any o(her sfafe or lecal law reyulafing consfn�dron o�the <br /> perlormance o/construction. That I am authorizeAby fhe owner o/this property fo perfom�fhe <br /> �rork!or which applicafion is made and I comply wilh fhe Sfate Confracfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> i <br /> ,/ i� <br /> � �`.+�_ T��-�J��'v �� '�'Cj " C.�,� � v <br /> tiignature Dat± —` ���JJJ <br /> !�� <br /> � <br />