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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT 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 /> `�0 � (,��1VCf2l,� �1U� C-�K-'��T�,z_JI� ��� `� <br /> PROJECT ADDRESS <br /> �-��11�i��u,�sE-��� 5����, ����a���ti�-�� ,2�� ���r�.� ��� ��-:�� �z��3������ <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenant Mail Address City SlatelZip Phone <br /> -1 C�� <br /> Eleclrical Contraclor ldail Address City Stale/Zip Phone <br /> Slate License Number Coniracl Price ot Work <br /> , -� 1� 1` <br /> Proposed Use o(Buildinq Conlact Person (Plan Review) <br /> Descriplion o1 Work to Be Done: ���l%�}�) `.'�G��=����i1� �k�h ��. G��{�.�5 l,l\ ���C�'l(��'� . � �l'�-�1 a�l <br /> t'�a�4�tl�-�:��� i�i_i���- ���Y���1 . i ci��Eaf 1,1����,.�,-tr�r„�i e�,'1�'�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, I�IC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily fliaf I have reaAand exarnined fhis applicafion anAkno�a•Ihe same to Ue true and (_ O�11.1. �C�L�'�� <br /> correcf. All provisions o/laws anAordinanr.es governmg this f}�pe ol�vork wdl be completed � <br /> whefher specilied herein or noL The granfing o�a permif does ncf �msume fo give authonty to <br /> violafe or cancel fhe provisions o/any o(her sfafe or local la�v regu�atinc�consVucfion or fhe <br /> pe�lonnance oI construction. That I am authorized hy the o�vner oI this propert}�fo peAorm the <br /> work lor which application is rnade anA I compty�vdh the State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,� , <br /> I �' � � <br /> �l1'���� U - j��i.1,�1�b2(�!1 �' I1��`j �, 7 <br /> � - Signaturc Uat I ' <br />