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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 - DEBIT& �REDIT CARDS ARE NOT ACCEPTED <br /> �)� l.,� C ,. l_r`.b_� ` �.i�� (- I �' Fl 1`�IC� � 1� <br /> � � LI1 �l �C` � �'. �\�: Z �� _i <br /> PROJECT ADDRESS <br /> �Ji� � � 1 ��i I� �� 1ii/ I� �� I � ��� �n � � 1 � I (��� c � 3 <br /> py,��e�� Mail Address r;�y State2p Phone <br /> C_� � �. � � . �� � t. <br /> Tenant Mail Address City StateIDp Phone <br /> -.s � r. <br /> J �1 '� � � <br /> 1. �. ��. . � r.\ � �, . 1:. r,r � � , Y ��' ��� � �� �`?C li ,,,6� ,, l. � • � ' 1 i 3 �> I <br /> Electtical ContraClor Mail Addres City Stale/Zip �,�, Phooe <br /> � 1- l� <br /> �". �� t: � 1;: c � U, � i] I`� `���'�C <br /> State License Number Conlract Price of Work <br /> �-�)f` ��� I.J�-.v 5 <br /> Proposed Use of Building Conlact Person (Plan Rev(ew) <br /> Description o(Work to Be Done: � �\ 1 r' �` � 1 1-- <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and know the same lo be true and <br /> wrrect. All provisions o(/aws and ordinances governing thrs type of werk will 6e complefed <br /> whether spea6ed herein or not The granting o(a permd does not pre<ume to give authority to <br /> violate or cancel the provisions ol any other state or/ocal law regulating consfruction or fhe <br /> per/ormance oI construcfion. Thaf I am autho�ized by fhe ownar of th+s property lo perform the <br /> wnrk for which application is made and I com ly with the Sfate Contiacfors Law 18.27 RCW and <br /> 296200 WAC. � � � <br /> � �. <br /> � <br /> ,� ,- ��� ,�",-�.� <br /> .. -- SignaWre ' . � � Gate ' . <br /> � b9� �� . . <br />