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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 <br /> ,� �r i <br /> � � <br /> �� r l %�i��C t�C��� I i(��E' �-��P �'����'L� i! � '�. ,.-,_ ��i �%C- <br /> PROJECT ADDRESS <br /> �() �� � � �� , ;`, <br /> �-11.����/ I��V � � �� � '� i � i������. �ik(� i��� ���J ��i� � ��- ( � � ,1 �--. C'�7•."- ����,�.���� <br /> Owner � Maii Address City State/Zip Phone <br /> �--� _ <br /> -1 itii:' �":i , `�(i�`'--\ <br /> Tenant Mail Address City State/Zip Phone <br /> I`v(��j� �� <br /> EleCtrical�ContraCtor Mail Address City State/Zip Phone <br /> � , <br /> r� ,, <br /> ��1� :�- �(�;C.: <br /> State License Number Contra f Price of Work <br /> ,� I � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �'���:�.,,�,��, �r��,`��it�''� ,� V_c":� 11 !�'�o t���`���vv �-� �v�''t?�, � ,<�v�•-C J� � �' ��,�` <br /> � . . <br /> �� � ��" �� I'� C � � �� ./� �� ' � �-�:._ .� )''1 < ��' �'��,.� C (�J <br /> , �„ , � , i, <br /> �. <br /> �j'. /i�i:n C�l�'�I'.� f��, �(��Z�1 ��L.� Li LCC��/�'7L���•r._�'� �����(.1.�%<'�' i <br /> J �J <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �;� <br /> 7_- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerfify thaf 1 have read and examined this application and know the same to be frue and ��!`��U``'"1 . <br /> correct. All provisions of laws and ordinances governrng this fype of work will be complefed <br /> whether specified herein or not. The granting of a perm�t does not presume to give aufhority to <br /> violate or cancel the provisions of any other sfate or local law regulafing construct�on or the , I CJG <br /> performance of construction. That 1 am authorized by the owner of this property to perform fhe �.� �Z�'�I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> n -- <br /> �l /i ��-�"''�- <br /> , <br /> �t, ,n'�� k� � ';�� � L- <br /> �,, �Sature � Date <br /> ,: <br /> i <br /> //. <br /> i � <br />