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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 -DEBIT&CREDIT CARDS E:'r2E NOT ACCEPTED <br /> �� C`; �� t� �`�w� � �C� <br /> PROJECT ADDRESS <br /> �Z�� <br /> 1ti1A7�1" Gl,i n,t��, ���� w�T��c�z ���r��r(" t�l�- :23�2 2'Z�a <br /> Owner Matl Atldress Cit <br /> Y State2ip Phone <br /> � P�"�{ <br /> Tenani Mail Atldress Cit <br /> Y State2ip Pho <br /> �AK� �-1 2� <br /> Qo�iT�z I�c.T�ickh� ,9�^� D;:n;. G s�v�n� t..);49i7�$' 33SJ�17y <br /> E�eclrical Conlractor Mail AAdmss City State2ip Phone <br /> ��as ��� � �c� �ti � �l �'D,oU <br /> State License Nwnber Contract Price of Work <br /> v A �� ��\ � �i 1 d �V���+�� <br /> Proposed Use of Bul mg Contacl Person (Plan Review) <br /> Description ot Work to Be Done: LJ \�^ 't j ��� �� j� (`/���L_ � n <br /> E �S� 5`Ti n a � C�c 0.`t� p�L� � �' � �W rR c,.� G v r v�,` � O l n\�— <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 IS 3105 <br /> I hereby ceriily that 1 have read and examined fhis applicafion and know(he same fo be true and <br /> correcL All provisions ollaws and oidinances govemmg tlus type o/woik will be completed <br /> whefher speaGed heroin or noG The granfing o/a pernut does nof presume to give aulhonty to <br /> violate or cance/Ore pruvisions ol any other slate or local law regu/ating construc(ion or fhe <br /> wu�k%r which appl c�ef on�s n a'de araid�l aor�iiply wit�th'e State ConfrectospLaw�8.27 RCW and <br /> 29G.200 lh'AC. <br /> ignature w� �� � � � � <br /> Dale <br /> ,;- <br /> C� 2- <br /> �-�U <br />