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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98207 <br /> 425-257-8810 - FAX 425-257-8857—wvuw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> ����3 �,:��%� �1�.�t���1 ; �c/C/'t� 1�,� 9D'".�-o/ <br /> PROJECTADDRESS <br /> �-.��-I ����M� �=� -- <br /> Owner —� MailAdaress �iry State/Zip Fhone <br /> �/�G �1'- CG� /lri/ �i�o����.,,,� � ;,R�._ /,c>/� 9��� (�r�-�I�s9- �iyt <br /> Tenant tdail Address :nry State2ip Phone <br /> �(i�h ���� -��'-1� - /S'1�3N� GJ'�'c� �%+m,,,d� ��A- `��'6S� (f,�S�`1's y�� �cc��— <br /> Electrical ContractOr Mail Adtlress f/ - (2p Ciry Slate/Zip Phor�e <br /> ��\1—�� � �- X�/ � �/L ';;,���� � / . ���� �� <br /> State License Number Contract Price o(Work <br /> �IQr��� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: 1�'��� C�� ��'I'� 7� ��°'`— !�� ���G���"•� /`�� �1�.t.�� '� <br /> .���`� � � � �'_�'nnt�^ �f- S <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 J105 . i� <br /> I 6ereGy ceRiry that I have read and oxamined lhis appl�caGon and kno:v tho samo to be true and r '�����?" 1�� <br /> correcf All p�ovisions ol laws and ordinances goveming this iype ol�ti�ork will be r.ompleted <br /> whether specilied herein or noL The granGng ol a permrf does not presume to give authority to <br /> violafe or cancel(he provisions ol any other slafe or bca/law regulaf�ng consfruchon or the <br /> perlonnanco o/construction. Thaf I am aufhorized by tAe owner of this property to peAorm the <br /> work lor which applicafion is made and I comply�vith fhe State Contractors Law 1827 RCW and <br /> 296 200 WAC. <br /> � �/���� <br /> ! <br /> ��� ignature DaYe � <br />