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ELE�TRICAL PERMII" APPLICQ►TION <br /> CI1('Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACC�PTED FkOM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> .�li�%�,T_�� �}'/�/� .S7 <br /> PROJECT ADDRESS <br /> �/ . � ./ �r� <br /> <�i1�1 lF��c'�w�l ,�����y,��l?�l �i✓d/^G'��� �0,1� �<F�h ���,���7 <br /> Owner Mail Address City Slate/Zip Ph� <br /> fd�� � _ <br /> Terant Mail Address City State/Zip Phone <br /> S!';��' <br /> Eleclrical Contraclor Mail Address City Slate2ip Phone <br /> Stale License Number Conlract Price of Work <br /> �J�� - �S� .Z..�� �l�J~ <br /> Proposed Use Builtling Contact Person (Plan Review) <br /> Descriptior�of Work to Be Done: � �(�(� ��'�'v%c�t• <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � � � <br /> I�. G7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 �� <br /> . 1 hereby certily fhat I have read and examined(his application and know Ihe same to be true and <br /> con�ect. All provisions of laws and urdinances�ovemmg this fype ol work will be completed <br /> � whether spec�Ged herein or noL The granting oI a pennrt does not resume fo give authority to <br /> violate or cancel fhe provisions ol any ofher sfate or local!aw re�uPting conshuction or the � <br /> peAornrance ol construc6on. That I am aufhorized by the owner of fh�s property to pedorm the n <br /> work(or which application is made and 1 compty wifh the Slate Contracfors Law 18.27 RCW and � �� <br /> 296.200 AC.��� � <br /> / / �i `� / v`, � �. <br /> ign8�r�—=����-` � Dale ,� � <br /> ,U <br /> �., <br />