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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-?.57-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i r--- ,� <br /> ��i �b�� �-� 'r, ���e 1,����- �c��r � <br /> PROJECT ADDRESS <br /> �1T�1C�-�� <br /> O�vner 61ai1 Address City State/Zip Phone <br /> TenaN Mail Address Cily SlaleiZip Phone <br /> Sc�rrrnlT�J_.ECT�-�C, b2vS '�ISr Si Nw STS�NWcuf� WA �i�,2j2 �-!Z5 Y1� 5�J j <br /> ElecUical Conlraclor Mail Address City Stale/Zip Phone <br /> ��,v,,r+,�l � i Goo K�Z. �75�0 <br /> State License Number Contract Price of Work <br /> ����� <br /> Proposed Use of �uilding Contact Person (Plan Review) <br /> Description of Work lo �c Done: (_+ ) I 1—� N�.� S•��� ' "� l�Tr�1 <br /> NOTE: WIRING IN NOh-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. : , <br /> i <br /> , <br /> _ }� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriily fh�l 1 have read and exam'ned this application and kno�v the same fo be true and <br /> rorrect. All provisions o/la�vs and ordinances governmg this type ol�rork will be cornpleted <br /> ivhefher spea6ed herein or noC The granting ola pernuf does not resume(o give authority fo <br /> violafe or cancel the�rovisions ol any other s(afe or local la�v reguPling construc6on or fhe <br /> perforntance o/cons(rucfion. That I anr authorized by the o�vner of lhis property to perform fhe <br /> �aork lor which applicafion is made and 1 cornply�vith fhe S(ate Confracfors La�v 1827 RCW and <br /> 296.200 WAC. <br /> �. ._� � ��. -1a) r'� � `�l <br /> •�Signature Date ^ � \ <br /> � ���i <br /> �. � I <br /> t <br />