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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT F�ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—Nnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM Tv 4 PM <br /> C� ! <br /> �7 ���� �>f/Il' P . ^ / <br /> PROJECT ADDRESS <br /> Owner � � Mail Address City Slale/Zip Ph�ne <br /> �i /� _ <br /> / G'`N J� �//=F� � ����J <br /> Tenant � Mail Address City State/Zip Phone <br /> Electrical Conlraclor Mail Address City Stale2ip Phone <br /> �✓L� V <br /> Slale License Number Conlract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> /l /, � % �// / <br /> Descriplion of Work lo Be Done: �(' /1�//_�� / • / � %���'/ / � / _ <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 hereby cerlily fhat 1 have read and e.ramined this application and know the same to be true and <br /> conecf. All provisions o/laws and ordinances governutg tlns lype oI work�vill be comp/efed <br /> whefher spealied herein or noL The granting o(a pennd does nof presurne fo give authonty to ,��0—Q l� <br /> violate or cancel the provisions ol any other sfate or local law regulating construclion or the CO <br /> perlormance o/consfruction. Thaf 1 am aufhorized by fhe o�vner o/this property to perlorm the <br /> work lor which applicalion is made and I comply�vith fhe Stafe Confractors La�ti� 18.27 RClNard <br /> 296.200 WAC. <br /> -� � <br /> /o- 5�.Z�S <br /> , SignaWre j Date <br />