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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.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i � � j ,{� �'�\�'� ��-1/�_ <br /> � � <br /> PROJECT ADDRESS <br /> �� �o��l� � <br /> Owner MailAddress Cily State2ip _. _ Phone <br /> ' _` <br /> � tix ��O �oi�I �� S � _ -- ,�c� h �S 5� oo� <br /> Tenanl MailAadress . City Slale2ip Phone �I <br /> .S'�� �('Y' � �-e�T''i� ' L� ��X lit/-, � ��3 � <br /> Eleclrical Conlrar!�r Mail Adaress , � City State2ip Ph <br /> \ <br /> s►�� � � �--� s � -�� -��1�� � � a <br /> State icense Number Contract Pri of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Wark to Be Oone: �e�✓V1 V'�_'— � � �� �Y�� � <br /> i <br /> I <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hr,reby cr.riily Ih?t I have read and ea�amined fhis applicafion and know the same to be true and <br /> corr�ct. AI!provisions ollaws and ordinances governmg this type ol work will be completed <br /> �rhefher speci6ed herein ornoL The granting ala permrt does nof reswne fo aive aufhonty fo <br /> violate or cancel fhe provisions o�any other slate or local law reguPafing constrnc6on or the <br /> peri�nnance oI eonstiucfion. That 1 am authoiized by N;a owner ol this property fo peifonn fhe <br /> work lor which application s made and I cenipF, !�i�h!Lc Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. � �^ <br /> , <br /> , <br /> f� „ L) <br /> ,..1 ,. � <br /> ;. <br /> 5lg�aWm Date <br /> � - <br /> � . �- � 0�:0 3 - �'Z�1 <br />