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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 NRE ACCEPTED FROM 8 AM TO 4 PM <br /> ,f , <br /> �i � �� - ;� �, i �.t ��'. �.c�c� ; I �'�.li,.r <br /> PROJECT ADDRESS ' <br /> i ' � l, — [ i SI `-., % i '' �.'�_'., i �� ���-�L ,' <br /> =� i �'��,, rl[.f(�L � �� {i l�r' � f�,% i�� i,: l� -- <br /> Owner Mail Address City State2ip Phone <br /> . ���IV �� '�l . � �1`� : ,� �� (. '� �'n�.;�.•�'��.; I.� . . r 1�',� ' G [(. 1�_�y f_ �..:,�i i �7(�_� <br /> Tenan� - Mail Address l Cily � State2ip � , r. P�one <br /> `7G ���:�S a� <br /> �-��� `��'I i � r i � -�1 : � ' •�'h�.�j �. •'�-lC ��1_I,l � � . i ' '--t_'l /� (�������—� (.�u,1 <br /> � ' <br /> Eleclrical Cohlraclor M�il Address' C�ty StatelZip Phone <br /> - l;� � <br /> � . �� �- �,�JL .1 . . - i :._ <br /> ' -,�`.I. ,'I ,. . - . I" � .. <br /> Stale License Number � Contract Price of Work <br /> �, > „ � I ' . .� I.:�:: �_ 1.. � '� I <br /> � ; P�� �� � <br /> Proposed Use of 6uiiding Conlacl Person (Plan Review) <br /> � � <br /> Descrlplion of Wo.k to Be Done�. � <br /> � �_ � I� �.� �':''..l � '� � l l .( (� ( I� i � � <br /> 7 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� �?=;� <br /> CITY OF EVEFETT LOCAL SALES TAX CODE IS 3105 <br /> '7 <br /> I hereb certil Ihal 1 have read and ezammed this application and know the same to be frue and r � �3 -- I�l� ' <br /> correcty All provisions ol laws and ordinances govemrng Ihis lype ol work will be complefed �- <br /> whether specified herein or noL The granfing o/a pemut does nof presume to give aufhonty fo <br /> violafe or cancel the provisions o/any other slafe orlocal law regula(ing construction or the <br /> peAormance ol construction. Thaf/am aufhorized by fhe owner o/Ihis property to peAorm fhe <br /> �vork lor which application is made and 1 comply with the State Confractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> ,} r 'i , <br /> I ( <br /> Sigrtemru ��, � D�le <br />