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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7� I�a�{ <br /> 425-257-8810 - FAX 425-257-8857 -wvw✓.e�•erettwa.org �� ��_�b� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 7 <br />� � �' L�� ,� ��- �/Z-K-/ 1� � ��iC- �� (,/� �� � ' � �i�`� <br /> , , <br /> PROJECT ADDRESS <br /> , i <br /> ;: � i�( 0 � � � i �� S �ll i.' c 7 i �'��� 1� '/� 1< � <br /> OWnCf Mail Address Gty Slate2ip Phone <br /> Tenanl �9ail Address Cily SlateRip Phone , <br /> i f I <br /> �;� � �IFt i 1'i� - /��+'C�� //76, f���� I'-�—�(L' �C��', �; ,-���� �1cP� =71 <br /> Electrical Conlractor tdail A�idress Cip� S�ate�Zip Phone <br /> � C' r r <br /> �, �: , ; � � ri �: � <br /> Slale License Number Coniract Price of Work <br /> Proposed Use ol Building Contact Person IPlan Review) <br /> Descriplion o(Work lo Be Dane: / i� v I�.�i�L� II �' �- �� `��� �-� < < t� �.v '/ <br /> � (� 1 l-��� +' r� li; � vlCi � ��L' Cl 111 /� <br /> NOi F WIRIIJG IN NON-DWELLINGS IS RE�UIRED i0 FEE <br /> 6E IN RACEWAYS, A1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I herehy ce�iily that I hu��e r<=ad and exarnined fhis app6cofion and know the same fo be hue and �JCl��� (�(�� <br /> conecL All prov�sions o/la�t�s cvnd ordinances gc verning(his type o(work rvdl be canplefed <br /> �vhefher specilieAhercin or not. The granting ut a permd does net resume fo give authonty fo <br /> violate or cancel lhe provisions olany other sfale or/ucal law reyuPfing consirucfion or the <br /> perfomiance o/construcfion. Tha(1 am autherized Gy fhe owner o/1h;s property lo perfomi the <br /> work Io�which applicafion is made and 1 comply�vith fhe State Con6ac!ors Law 78.27 RCW and <br /> 29G.200 WAC. <br /> ,, i <br /> 1 . , <br /> Si�naturs Data <br />