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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ei�' 7 l�iG'�.J��C-Si �i°dC" _/;'�%�F%1 1�1��,� <br /> PROJECT ADDRESS <br /> Noc� ��,�< < .2�a� 1r����,���c��ti�d<! cce,�� ��� 9��,��7 y1s,3y,�i� �� <br /> Ownef Mail Address City State2ip Phone <br /> �/�/ <br /> Tena t f.lail Address City St�te2ip Phone <br /> J�t/� <br /> Eleclfical COnlfactor A1ail Address City Stale/Zip Phone <br /> Slale License Number ConUacl Price of�Vork <br /> �l;J��[ lZlt%.DC'x.(Y <br /> Proposed Us of Buildinc� Conlact Person (Plan Review� <br /> oes����i�o�orwo�k io oc oo�,o: /'.o:== o��ic iJ r'r�-r /7/T�'r>/� �✓/�G c'_ <br /> �x!' •.iJ .J ..vC ' /J C ' �' .,G�(,�.C�Lia�,�o vT/c ; ?{/ <br /> J <br /> ��.���—, (IJT(. Cll . _ __ <br /> NOiE WIRING IN NON-0�'VELLINGS IS REQUIP.E^ TO FEEJ <br /> f3E IN RACEWAYS, MC OR AC Ci�` LE. <br /> .�> <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cnrtify fhaf 1 havc mad and ezmsincd Ihis applica[ion and know Ihe same fo Ue frue and <br /> conecL Au provisions o�laws and ordinances guveming fhis type ol�rork will be complefed <br /> �ti�hefher specAied herein or noL The�ranting ol a perrnit does nof presurne fo give authonty fo <br /> vio/afe or cancel(he pro��isions o(any other state or local law regulating construchon or fhe <br /> pertormance o(conslruction. Thaf 1 am aufhonzed by fhe owner o!ihis property fo perfonn(he <br /> work Ior which applicafion is made end 1 comply with the Sfafe Confracfors Law 7827 RCW and <br /> 29G.200 WAC. <br /> �i�� � ���� <br /> Signature Date <br /> �-" �U�L�.�-�l�J�� <br />