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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 /> ���`� y �'�� S�' S�, � <br /> PROJECT ADDRESS <br /> C�,ro\`( v� U , �< Cos <=� �. II `� �(���5 � s• L I�.K�C �,,� �'`''�y <br /> , <br /> Owner Mail Address Cily State/Zip Phone <br /> U ,,�3 3e�G � <br /> Tenanl Mail Address Cily Slate/Zip Phone <br /> Q t.�w��' <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> ��p -y� � I i <br /> Description of Work lo Be Done: �,IJ �( \ ��� \7p„�h-l`�TC`-� � _ 6�(`}�`� <br /> NOTE: 1A'IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihal l have read and examined this application and know the same to be frue and <br /> conect All provisions ollaws and ordinances governing th�s type o/�vork will be completed <br /> whefher specihed herein or noL The granting o(a perm�t does nof preswne to give authonty to <br /> violate or cancel Ihe provisiens cl any other state or local law regu/ating construction or fhe <br /> perlormanr.e of construchon. That 1 am authorized by the owner o/this property to per(orm fhe <br /> work(or which application is made and 1 comply with the Sfate Contractors Law 18.27 RCW and <br /> 296.200 IhAC. <br /> ;��%''.�'�, <br /> � � � 1 - 0 � <br /> SignaWre Dale <br /> � ctooZ - I l � <br />