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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 ACCEPTEU FROM 8 AM TO 4 PM <br /> 1 "1 , , <br /> -i ; > � �! '� T 1` ��� �,��' ��L� C�' f� ��l <br /> PROJECT ADDRESS <br /> _ '�� .a �L�, <br /> Owner Mail Address City State/Zip Phone <br /> — ��— <br /> Tenant Matl Address City State/Zip Phone <br /> l� l 'r �;'� � -' �� r/ f� . ? ?ul illv��. �>� ��'� !=v �v/� �;�� � �3 ;sS-3�Y <br /> Electrical Conlractor Mail Adtlress City Slate/Zip Phone <br /> /� l � C� v�'� �i% � �i'l% ���L:�,�J °� <br /> Slato License Number Contract P ce of Work <br /> �'_ <br /> / � �� <br /> Proposed Use of Buildinc� Conlacl Person (Plan Reviow) <br /> � ' , <br /> Doscnplion of Work lo�e Done: � � j i J� — f' �, C/ / /� �n> / � 7 'i n i � � � �'6� Vi� (' <br /> �;� •7 .n ) . i � � <br /> �- �cl, . . L�'�� i C�t' � l �:i � � 1�'l% �� l-� L l.%?C,�i> <br /> � - <br /> 1� �7S��ff,�-',Ci� ( /'C IJ X�' C /�'%7�1 <br /> � ' _—_ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIT1"OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and exnmined fhis application and know the same fo be true and <br /> correcL All provisions o/la�vs and ordinances govemmg fh�s type ol work will be cornpleted <br /> whefher specified herein or not. The granting ol a pennrt does not presume fo give authonty fo <br /> viola(e or cancel O�e provisions oI any offrer stafe oi local law regulatingpconsVuction or the <br /> �i�i o k fo��vh ch ap�liea�i���'s n a�de aAd�l eo'nptyedt�ihe Stafe ConfractorspLe v 18.2 R W and <br /> 296.200 WAC. �j � I� <br /> I ` i' i / — � _ ,.. ._y l <br /> i f � �G' 1��.�i �� � . T <br /> Sgnature Date <br />