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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 /> �� C"��� ` ��:C,�� � C CL��� l��L ����� ���.�i��c ��S �. <br /> PROJECT ADDRESS <br /> � �– <br /> d`.,�_� �� �> j � � Z�=3���-3j 7 <br /> : C�' ��\ ���-� LU:.w�-\�����`t'k--L� �`-�G=� _ ��ZG>1 ' <br /> � <br /> Owner Mail Address City State/Zip Phone <br /> C' <br /> �1�'C,1�(j 1�1,'.,l,� �� �i.��.w � �� +� <br /> Tenant Mail Address City State/Zip Phone <br /> �vv -���3 <br /> ,,�'�, l�`�L �� ��7'�--�CJ �-I,.5f1�--�7 Z�� ��S� �1'1 Ua�/���� C����-`����� �r c�l <br /> Electrical ContraCtor Mail Address City State/Zip Phone <br /> �/ .4-/�`� �� � ! L'� �✓L� � .� �7���� <br /> State License Number Contract Price of Work <br /> a <br /> C�'��-��� C�z�2�ti ���� ���-�L <br /> Proposed Use of uilding Contact Person (Plan Review) <br /> Description of Work to Be Done: 'rl/ �� l.�l 1c' C w\�-S `��� <br /> � <br /> � S .v '� �Ci v�/ " � MC�-���.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� '�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be frue and � � � � —O� O <br /> correct. All provisions of laws and ordinances governing th�s type of work will be completed <br /> whether specified herein or not. The granting of a permit does nof presume to give authority to <br /> violate or cancel the provisio any other state or local law regulating consfruction or the <br /> performance of consfruction Th't I am authorized by the owner of this properfy to perform the <br /> or r which application i mad�and I comply wifh the Stafe Contracfors Law 18.27 RCW and <br /> 96.2 WAC. <br /> �11�� v�`-'�_ <br /> Signature Date <br />