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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 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /%/�� ��� �S � <br /> , � <br /> PROJECT ADDRESS <br /> !� ,i.c;��c�. ..�.�. ��=s_-._<- - --� <br /> � <br /> Owncr A1all Addmss City StalelZip Phone <br /> Tenanl Mail Addmss City State/Zip Phone <br /> 1-�S ✓ .Z�/l 7� S� S � i=�,�� r w� 5 � ��� � 5S S.�Y� <br /> Eleclrical Conlraclor tilail Aduress City Slate/Zip Phone <br /> ��C (� �/. �" U.Z.,Z �Z - �>.. .�— <br /> State License Number Conlract Price oF Work <br /> ff<u 5-F <br /> Proposed Use oi Building Conlact Pcrson (Plan R�view) <br /> Description of Work to Be Done: -�� � � ' • '�' ° 4 ' �`�4 �-� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certify fhat 1 have read and exarnined this application and know Ihe same to be true and <br /> � correct. All prowsions o/laws and ordinances�ovemmg this type olwork will be completed <br /> '� whefher spe..ified herein or noL The�ranfing o(a pernuf does not resurr,e to givz authority to <br /> violafe or cancel the provisions ol any other state or local la�v reguPfin�constru�Uon or fhe <br /> perfornrence o(construchon. That 1 am aufhorized by fhe o�vner of fhis property to peAorm tlre <br /> work(or which application is made and 1 comply wifh the State Contractors Law 18.27 RCW and j I <br /> 296.200 WAC. <br /> �, I , � <br /> / , �y9 <br /> � ! <br /> ��4-� �(/C��- �-�� � ���.. <br /> � Signalur j" Date ``y <br />