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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� _ZZ,-07 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� .7� �.�� 7 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� , �,' �^� � � 1-1 U� <br /> PROJECT ADDRESS <br /> ,- . � r: <br /> t��; •_ . �.:., � 1 � , - ,. . , ; � i'_ I*�,..;:-- i;�.� ,Jc.�t'r • i• 1G, `�� 2FJ( 4zi• z s� 08 8 <br /> Owner , Mail Address City Slale/Zip Phone <br /> �l.inP r�.� �-?�,h• <br /> Tenant Mail Address Cily State2ip Phone <br /> � <br /> � �:.' �;, i� 1��� � { -i, L• � �J 9G� % � yzSS77 ' 6 /� <br /> l� �. l:iL. � �r � � ..I; ., ln.u.��� n . i y• �i <br /> Electrical Conlraclor A4ail Address Ciry State2ip Phone <br /> �lC �i� ��r ��. ;,�-i�� � ��� og�. o� <br /> Slale License Number Contracl Price ot Work <br /> .,,.� i:� ,rc „ri/ . .�. <br /> Proposed Use of Buildinc� � Conlact Person (Plan Review) <br /> �1 � . <br /> Description ol Work lo Be Dona ':/;i/:� � /�*� /. %' .:,J ���t: i��.�,/ �!-.� �- -k.� ���Ui �4.. W� <br /> i �/ <br /> �� /�� '"�'r� %�. � � )11f �' F �00/: C� ��fFi��c � � L-�c, �v�r 410�dhJll�f. <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 here6y ceAily fhaf 1 have read and examined fhis applicafion and kno�v fhe same fo be frue and <br /> conacL All provisiens o/laws and o�dinances goveming th�s type o/�vork will 6e complefed <br /> �vhefher speci6ed herein or noL The c�ranting of a pernut does nof presume'�give aufhonty to <br /> violate or cnncel fhe provisions o!any ofher stafe or local law reguretmg cons:��chon or the <br /> peAomiance o/consf�uclion. That!arn aufhonzed 6y Ihe o�vner o/fhis propeRy fo pedorm the <br /> work Ior which applicafion is made and I comply with tHe State Contractors Law 18.27 RCW and <br /> 29G.Z00 WAC. <br /> \ /�_ J„� _J .i <br /> Sic�nature Data <br />