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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 —wv+w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `.� � �O� <br /> , r, <br /> . � ,' ,�` , � 1,�, i" .'i� r _ / ��� c� �C� / �� � � <br /> PROJECT ADDRESS -� <br /> �J . _;- <br /> ���l �� �/ � �= L�(�� C � � <br /> Owner Mail Addross City State/Zip Phone <br /> , <br /> "� . , :7c� � (.. ) <br /> Tenant A1ail Address City Slale2ip Phonc <br /> " �'%�c:7i/5�1 C C' ���� �'/ '�C' ��/,/`J i ��i':�'^(�.7/"/ ii��J 7/���� %''�:� t� �l:��. � %,)j�L: <br /> Eleclrical Contraclor Mail Address Gty c, Slate/Zip Phone <br /> ���1 ,,,�...f� C f,-�.�j <br /> , �� , � ���, , �S �=>/-� �/JS 7� 7�j7 �°�-,�-�, <br /> Slale License Number Contract Price of WorF: <br /> , .' <br /> � ��..7�J n��/<�/ 7 �-��/C c� <br /> Proposed Use of Builtling Conlact Person (Plan Review) <br /> Descriplion of Work Io�o Donc: � —��,�% <<i�;%^ ,"!`���!��-,� �,';'" 'F ' <br /> � <br /> i <br /> ��. '.�'; .-i� '%�r�/"— °c'/� L�/.�� �:Iq/.���"`:� `�l ' .`r/- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and esamined this applicafion and kno�v the same to bo t�ue and <br /> correct. All provisions o/laws and ordinances governmg fhis fype ol work will be completed <br /> whether speciGed herein or noL The c�ranfing o(a pemut does nof resume fo give authonty to <br /> violate or cancel the provisions ol an}�other state or local lu�r reguPting construction orthe <br /> perfonnance o/consfrucfion. That I am aufhorized by fhe o�tner o/fhis properiy to pedonn fhe <br /> work lor�vhich applicafion is m�de mid I cornply wifh the Sfate Conhacfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� <br /> )�� �� � <br /> Si�na�uie Dale �(� � <br />