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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � - -�` <br /> ��, �.�, <br /> l...i, i � 1-%� <br /> PROJECT ADDRESS <br /> �- � � " <br /> ,<�� - �'�y—��f`'.J � <br /> ��;�C.�.� .�l/�/��si� L�� �`J-���LJ �.,-� �c),.::�';%/ ��/7` ��J�:/ <br /> i <br /> Owner � Mail Address Ciry State/Zip Phone <br /> Tenant Mail Address � City Slale/Zip Phone <br /> E_��;!�i;<�i' i���t.�'j�;;-<i i`�'/,r-_'2'��, i�!' ;��'�%G <br /> , <br /> Electrical CoMractor Mail Address City � ` Slate/Zip Phone <br /> State License Number Conlract Price of Work <br /> Proposed Use of Buildin� Conlacl Person (Plan Review) <br /> n, � / <br /> Descriplion ol Work to �e Done: �'���L�- ��<� �`-����C.�c...� ��l��1�:/�� <br /> � �� /�, <br /> ` . '1/,%C �/.,, c� .C.��U�-� ���= ���` <br /> . � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certil}�(hat I have�ead and examined this ap�licefion and know Ihe sanre(o be Irue and <br /> corroct All provisions o//a�ti�s and ordinances govemmg fhis type oI work will be completed <br /> �vhether spealied he�ein or noL The�ranfing ol a pennd does not presume to give authonty fo <br /> violate or cancel the provisiais o(any other state or local luw regulating construcfion orthe <br /> peAorrnance o/cons(ruction. That l,rn authorized by the owner ol this property fo pedonn fhe <br /> �vork Ior�vhich applicafion is made and I cornply n�ifh fhe Sfate Confractor;Law 18.27 RCW and <br /> 296.200 11!4C. j <br /> � ` , / / - � l % <br /> L(.,. . �-,. �;C j / �'_ _� , - J ;� <br /> � � .�- " L ,� /t� ��. <br /> Sipnat�re� � Date � <br />