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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 /> is�� �i y '� s�s w �� Z <br /> PROJECT ADDRESS <br /> �'`��j .�i7 cr� 5�`v,7, �.J <br /> Owner Mail Address Cily StatelZip Phone <br /> Tenant Mail Address City Slale/Zip Phone <br /> wy� �/ c-7,���r;��i.� c �U�i 7 (�/S'/�r� it/L`/�.�*'ii>�sv,/,• w� �Fr Z >o <br /> Ele rical ConlractOr Mail Address City � Slate/Zip ��S—b, 7v Phone <br /> �ifi�— <br /> � <s(/ ����/��� ,lT� �-S vC� <br /> Stale Li ense Number Contrecl Price of Work <br /> 5 � � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /� ' l'�vS� /�CiC� ,S C� � <br /> Description of Work to Be Done: ���Cti� /C fs! <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 /> I hereby certily that I have read and examined fhis application and know the sarne to be true and E G��0 —�y� <br /> correct. �ll provisions o/laws and ordirances governmg th�s type ol work will be completed <br /> whether specified herein or noL The granting o1 a permrt does not preswne to give authority to <br /> violate oi cancel the provisions o/any other state or local larv regulating construction or fhe <br /> pe�forrnance o/construction. That 1 am aufhorized by tlre owner o/fhis property fo peAorm the <br /> work Ior which application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> —�,��—c ��' ld c'�(o ( cJ 7 <br /> Signalure Date <br />