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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SFRVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AIJI TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />2tir � �rf %r�r� ��v <br />PROJECTADDRESS <br />�!� ��r1�7/iwa Il"��%'- 2`I t � <br />Owner <br />Mail Addmss <br />�i� �� � V.Zvc I I <br />City <br />`f ? � - 7`7C 76' <br />W� �V�>> <br />Stalc/Zip Phone <br />TeneN MailAddress Ci1y Slate2ip Phone <br />`l21�-S'YS=z i ,� <br />� r�vi;F�v !'�e c���c 700Y (�'04'`. ��..r r�lC t�b���c:�;o G.,N `1���� Z— <br />EleCiriGal COnlfaClor Mail Atldress City SIa�e2ip Phone <br />C r.�� ,rc��r� a- �iz � c��r �'� <br />Stale License Number <br />Propused Use of Building <br />��� • �� <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />Descnption of Work to Be Done: �1 � C- i' � 1��� �� ' T �� ��n�T <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />1 hereby certify fhat I have read and examined Ihis application and know the same lo be frue and <br />correct All provisions ollaws and ordinances govemrng fhis type oI work wJl be complefed <br />whether specified berein or not The granting ol a pemut does nof presume fa give authonly fo <br />violate or cancel the provisions o/an}� o:her stafe or local law regulafing construchon or 1he <br />peAormance o� constn�cfion. That 1 am aufhonzed by the owner o/ fhis property to peAomr Ihe <br />work lor which application is made and 1 comply with (he Sfafe Contracrors Law 78.27 RCW and <br />296200 WAC. j'� <br />FEE <br />�� <br />.' �,� �� <br />i <br />