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ELECTRICAL PERMlT 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 ACCGPTED FROM 8 AM TO 4 PM <br /> �'0 7- �9 8�� S-f � u� <br /> PRO IECT ADDRESS <br /> �ZS <br /> � ? I'{�R`�''L_ G II�J- �(Oy� S I J�` C IJG.� II WA �02a3 2)3'�IYyz <br /> C i r7�� <br /> Owner Mail Address City Staie/Zip Phone <br /> Tenanl Mail Address Ci�y Sta�elZip Fhone <br /> Eleclrical Conlraclor Mail Address City S�ate/Zip Phone <br /> State License Number Contract Price of Work <br /> L7/� •�- �Arz'i"L <br /> Proposed Use of Building Contac Person (Plan Review) <br /> Description o(Work to Cie Done: : �✓ �,�.�,--� -� r✓ o<?��Cd i J J �r� <br /> NO7E: WIRING 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 ceAily fhat I have read and examined fhis application and know fhe same to be frue and <br /> co�iect. All provisions ol laws and ordinances govemmg(lus type ol work will be complefed <br /> whether spealied herein or not The granling o(a pernut does nvt resume to give authority to <br /> violate or cancel the p�ovisions olany other state or local law reguPfing construction or th= <br /> perforrnance ol construction. Thaf 1 am autherized by Ihe�wner oI thi�property to peAorm fhe <br /> work Ior�vhich applicalion is made and 1 comply witB fhe S(ate Contractors Law 18.27 RCW and <br /> 296.200 vVAC. <br /> % <br /> i' �i� ' ���� �=1�('I- C7� <br /> Siyna�ure SI/-- Date <br /> �G�c�7-� 6 c� <br />