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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 / � � � 9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �yQ�/2-�O <br /> � Z�SC�O � �I �" �� .`�L _ <br /> PROJECT ADDRESS <br /> �--- _ <br /> i ; <br /> ���� li��V�(-k, ���_��.�L ��" �'� � ��L (�. <br /> Q er Mail Address Clty StatelZip Phone <br /> Tenant Mail Address City SlatelZip Phone <br /> i ' c <br /> , �. <br /> � �,���"Ci'l,�v�,' �>,� .� Ci�(i% l�� �-�W�1 ��� U(,1�'1�l'l�t��; l�►-� '��_� <br /> EICCUiCaI Con�reclor � A ail Address City S�ate/Zip Phone <br /> Slale License Number Contract Price of 1Nork <br /> � <br /> � '���(�l( �.U'i <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � {� ` I/ I 1 '�� <br /> �ESCfijiii'viiJi�r°rvin"i'vu� i�vi�v: � � � j �� .��li_i.,L\ Y� iv� ILi�}il:�"�C-`�'�_ <br /> I�c ' �� _,'_���.a � <br /> �' <br /> NOTE: WIRING IN NON-DWELLINGS IS FEQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I have read and examined this applicafion and Imo�v the same fo be true and <br /> correcL .411 provisions olla�vs and ordinances,qoveming fhis t}�pe o/H�ork wi;(be completed <br /> whefher specdied herein or nof. The c�ranfin�o(a permd does not�resunie fo give authonfy fo <br /> violafe or cancel fhe�rovisions o/an}�other state or local la�ti�regulating construcfion or the <br /> perfonnance ol consfruction. That 1 am authonzed by the o�sner o(this property fo perform fhe <br /> work lor�vhich appliealion is made and 1 cornply�•+ith fhe Stafe Centracrors La�v 18.27 RCIN and <br /> 29G.200 IVAC. <br /> r <br /> �, ����� , :�.��.:�: \ �,ti — <br /> Siqnature Dafe <br /> � <br /> _- i,i�i r-i j,:�� <br />