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ELECTRICAL PERMII' .4PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA,98201 �O� /y (/ <br /> 425-257-8810 - FAX 425-257-8857—www,everettwa.org �/ 6� 0 <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM -DEBIT B CREDIT CARDS ARE NOT ACCEP7ED <br /> 3`� �x W�v�. �r, 1=�ere�- 9S��o 3 <br /> PROJECT ADDRESS <br /> ��-��� �r��,-.�� �y� �� ��.���� ��,� ���e�- c�w��aa3 <br /> Ownef Mail Address Ciry Slate/Zip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> [lectrical ConUaclor Mail Address Ciy State/Zip Phone <br /> Slale License Number Contracl Price of Work <br /> 7`/�Ci �C 1N11 � �� SIG� Y!( Q <br /> Proposed U of 6uilding Conlact Person (Plan Review) <br /> �=.scription oI Work to Be Done: �l"�..�� ��� UC�/) / 11 � / /�% n� ' "� �n / ' � <br /> � <br /> •\ �J� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO� FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I he�eby ceAily(hat I have reaAand examineAlhis application and know fhe same to be true and r(;�y(:�y: -�j(�:1 <br /> � conecf. All provisions ollaws and oi�iinancas governmg fhis lype ol u�ork will be conrpleteA <br /> whelher specilied herein or not The qranlinq o/a permd does not presume fo give aulhoiify lo <br /> violale or cancel lhe`�rovisions o/nny olher stafe orlocal law regulating consfruc6on or fhe <br /> perlom�ance o/consin�cfion. That!am aulhorized by the owner o/lhis property fo periorm fhe <br /> work lor which applicafion is made and 1 compty wifh fhe Sfate Conhacfors Law i8.27 RCW and <br /> 296.200 WAC. <br /> � � � <br /> ,�/ / / �� : <br /> , ti i i � _ <br /> _ - lgnatcfre Dale/ <br />