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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM <br /> .���S �� L T�'�c��E L1.- �`�i I ��% i� . <br /> PROJECT ADDRESS <br /> �r=�-1�y- ��Yp <br /> '�C, �N �' �r�c.��ii= , 2���a-I �� �;2�c�� �L S/��-rK �v/�� - <br /> OWner MailAddress Cily Stale2ip Phone <br /> �V � N �� � L� � �� �1 <br /> Tenanl Mail Address Ciry State/Zip Phono <br /> N�/a_ <br /> EleCtrical Contraclor Mail Address Ciry Slale2ip Phone <br /> �.�.CZ� <br /> Sta�o License Number Conlract Price of Work <br /> a f ti+C�C L•= v�\t-1I L�I I{�'�`�l� <br /> Proposed Use o(Duilding Conlact Person (Plan Review) <br /> Description of Work to De Done: �p� ��(�`�(, 1� �L6 �j�l,� TD �-T�'v�L <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I hereby certi/y tiial!lreve read and er.amined fhis�pp/ication end know fhe seme to be true and <br /> comecL All provisions ol laws and ordinances goveming this type ol work will6e complefed <br /> whether specdied herein or not. The granting ol a permrt does not�,resume fo give aufhonty fo <br /> violate or cancel fhe provisions ol any ofher state or local law re,qulating constructwn or the <br /> perfonnance o/consfrucfion, Thaf 1 arn aufhonzed by fhe owner o/fhis property to pedonn fbe <br /> work loi�vhich application is made and I comply with the Sfale Contracfors Law ]8.27 RCW and <br /> 296.2001NAC. <br /> / � ) i� �, <br /> ,4{,�U��, ,`�1,� ' w 7S�3�L�4� <br /> � Spnalure Date <br /> �u�Gh -(� <br />