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� r <br /> 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 8 CREDIT CARDS ARE 110T ACCEPTED <br /> ��C� � v��r ' �'����� _ �„��� S7U-����. <br /> PROJECT ADDRESS <br /> ����ol <br /> , \ �� � - –� --� c' ,. -,c,r '' l <br /> �J V�\1`� f' __> `� r� iJ �i, �� ._ �'� V—��J� J � v' c.. �Uv.C'n`G !�. �v� <br /> c <br /> Owner Mail AddrEss City State2ip Phone <br /> �SD ; �r= -rm�,�= �� v� 9 k���, i y�s �� so -� �� <br /> Tenanl Mail Address Ciry State2lp Phone <br /> �`�J h�SZ.O�9� 1�.2'lfC� d� (� L,p.�_S_> -'� �r�U ���'f 1� UJ di lU�'�'G�'�-�'�i�- <br /> Eleclrical Contractor Mail Address Ciry SWIe2ip Phone�� <br /> 9�.s" � �a <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> DescriptionofWorkloBeDone: <� ri'h%"�' � C��" � � 7��� '�;�/ �,��El� �•�'�'� <br /> �� <br /> r'r.':��� 'it�.� � %/7.t`':,-)7/;'., <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. � — <br /> CITY OF tVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriify fhat 1 have read and examined fhis application and know fhe same to be true and <br /> correct. A/l provisions ollaws and ordinances goveming fhis fype ol work will be completed <br /> whelher specified herein or not. The granting o/a permd does nof presume to give aufhority to <br /> violate or cancel fhe provisions o/any other sfafe or local law regulafing constructiun or fhe <br /> perlormance ol�onstruction. That 1 am aufhorized by the owner of this property to peAorm the <br /> work(or which application is made and 1 comply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. / <br /> .,,� i � <br /> �,�%��l� 9 / /��` D; <br /> � <br /> % <br /> Signalure Date <br /> �� � "/� <br />