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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"vs �r�� sr.� w ��r� <br /> PROJECT ADDRESS <br /> �/-> vt 3�G� �r'rn / <br /> Owner Mail Address Cily State/Zip Phone <br /> Tenanl ldail Address City State/Zip Phone <br /> �[iLi � C��C IYiC �iC SCXJ 7 �/ST/�� /v� ���yJG� ��� L�/s'¢ �T�Z 7�j <br /> Electri al Contractor Mail Address City State2ip Phone <br /> �yG 7C_-� �� S�s�� _ _� �-�� - <br /> y �.S�jVS`Y ('_ <br /> State Lic nse Number Contract Price of Work <br /> S l� l� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Done: �//Y r^� /c f 5 i I��'�S P / `�(�� S q r <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 certily that 1 have read and examined fhis application and know the same to be true and EU, t� _� �—(lp <br /> conecL All provisions of laws and ordinances govemin�fhis fype oI work will 6e complefed <br /> whe(her specilied herein or noL The granting oI u perrtut does not preswne to give authonty fo <br /> viola(e or cancel fhe provisions o(any other state or local law regulating construction cr the <br /> perlormance of construction. That 1 am authorized by fhe owner of fhis property fo pe::orm the <br /> work Ior which applicafion is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> _ '� �-' ' � ������ / � � � <br /> ��i `/� � <br /> .lSignature Oate <br /> / � <br />