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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRtET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�n�ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> �`�o� 5 +� S-�r <br /> PROJECT ADDRESS <br /> .1L;_�.G; �1r,��r��e a�Yoy S�'S� �-�re �,,/% l��l <br /> ONmer MailAddress Cif/ Stale2ip Phone <br /> Tenant Mail Address City Sta�elZip Phone <br /> Y�ZJ <br /> /�/rliG ��4.5 Fi c�cc��� /blo6 h'l�cl�o�/�� ��C�l�o.� ti/� 99d�3 �7��C� <br /> Eledrical C ntractor Mail Address City :�tate2ip Phone <br /> 60� g�y ��o <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contad Person (Plan Review) <br /> / / � <br /> Description of Work to Be Done: � �'e✓!,'t1�f t O/ �h�� 4i� N 7��+ L� I c�/� P <br /> l � � / <br /> �/1P .fJ //_ t. e 1 / Q�/ lw7i�'/�� — �0 �P �'U�tF` C�i � No <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TU FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 �` C)a� <br /> 1 hereby certify Ihat I have read and examined fhis application and know fhe same fo be true and �,�J � <br /> conecL All provisions o/laws and ordinances goveming this type ol work will be completed <br /> whefher specified herein or noL The granting ol a permrt dces not resume to give aufhonty to <br /> violale or cancel the provisions of any ofher state or local law reguPhng constn�ction or the <br /> perinrmance o/consfruchon. Tha�I am airthonzed by the owner o/this property fo peAorm the <br />� wor1�Ior which application is made and I comply wifh(he Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �j� C 7 c, <br /> // �a ��c�-•-•--._- 7 —l7 �� 7 <br /> Signalure Dale <br />