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li <br /> ELECTRICAL P�RMIT APPLICATION 'i <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> i <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & GREDIT CARDS ARE NOT ACCEPTED I <br /> i <br /> � , — � �-'� �� -,- <br /> L:� . 5 J � � r _ � � <br /> . . ; . <br /> PROJECT ADDRESS � <br /> �f�%�=sr"'-��_ <br /> Owner Mail Address City Stzte/Zip Phone <br /> ` �- <br /> ;--�r�^i '� o;� °� �/�Z, 5— >%; , �7 -, . , -, `� ', <br /> � ' / /—v�, ti,�7' V�'!� �iY_c�% 3�� - J=.�'�; <br /> Tenant Mail Atldress City State�Zip Phcne <br /> -- `�/�rli�-^��- 5.�r,g d �r',t,;i�. �-� ._._ ��4����1i-v�j'-LL ��/fG!,� ��'�� �:S�ZG�� yl � ���� -��� <br /> Electrical Canlreclor Mail Address City State/Zip Phone <br /> ;���/,� d <br /> State License Number Contract Price of Work <br /> C� [��!/j/,' If��C � �4 / <br /> Proposed Use of�uilding Contact Ferson (Plan Review) <br /> Description of Work to Be Done: !�`'��� %���% ���' �' P J�'��« f � "�-��l <br /> J <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� <br /> � ��. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 nereby certily tha[I have read and examined this application and know fhe same to be frue and <br /> cerrect. All provision�ollaws and ordinances goveming this type o(work�vill be completed . <br /> �vhether specdied herein or ncL 1'he granting o�a permrt dees not presurne to give authonty to . <br /> violate or cancel the provisions of any other state or local law reaulating cor,strvcricn or the <br /> peAormance e(construction. That l am authonzed by the owner of this property tc oeAorm the i <br /> work (or which application is made and 1 comply wdh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ����� ��',u����S 1 I /2! �G �' !, <br /> 6ignawre � � e � <br /> ✓ �i � <br /> • I <br /> . . �� li �- . . . v I <br />