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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��/ Yi� sis��/ G Ui G ���,%� �Ti <br /> PROJ ECT ADDRESS <br /> 1�� ���j� (Gl�S (7aa.���7/ <br /> Owner 1�1ai1 Address City Slate.2ip Phone <br /> Tenanl Mail Address Cily StatelZip Phone <br /> ��y�=�G-%c�i'i c ��c SUcU 7 �i'/ST,�/�.�1=t���s' s�r/r� C�r9�''.�Z 7U <br /> Ele�al Conlractor Mail Address Cily Stale/Zip �� Phone <br /> �7��s�-S� <br /> ���i l�G=.� l �Sl�`�f—� � �GZ�ci <br /> State'License Number Contracl Price of Work <br /> ����� � G��� C? � � / <br /> Proposed Use of Building Contacl Person (Flan Review) <br /> / r <br /> Descriplion of Work to Be Done: ✓i'`f-'Le ) `�"�� S C ��jG/�� S � <br /> NOTE: 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 /> 1 hereby ceRily lhaf 1 have read and examined f�iis application and know the same to be Vue and <br /> correct All p�ovisions o(/aws and ordinances governmg Ihis type of work will be completed <br /> whether specilied herein or not The gran(ing o/a pernut does not resume fo give aufhority to <br /> vio/afe or cancel fhe provisions of any other state orlocal law reguPling constructron or the � I� � <br /> pe�lomiance o/construchon. That I am aufhorized by fhe owner o/this property to peAorm the ' J <br /> work lor which applicafion is made and I comply with the Stafe Contractors Law 1827 RCW and �^ <br /> 29G 200 WAC ---� <br /> i -; <br /> i <br /> - ��/ � ' � <br /> � '_! �.������ . _ _ ----> <br /> Signature Dale <br /> �, <br /> � <br />