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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����� ��C�/,��G�. <br /> PROJECT ADDRESS <br /> ����i��' �y� 3r0Y �I��P�i�e, %,ie�� �i� �fZS'���,��"� <br /> Owner MailAddress City Stale2ip Phone <br /> Tonanl Mail Address Cily Slate/Zip Phone <br /> ��u,��������� 133�i/'�r����l����-fh�'��63�'I�GGI�,M-II�r�E: o��r�ySGi�- �l�'����G�r <br /> Eleclrical CoMraclor Mall Address Clly ate2ip Phone <br /> ���u-h�,�' %`/���C ��JQ <br /> ato Ucenso Number Contract Price of Work <br /> GGr�r.� r•%i�c j <br /> Proposed Use of Duilding Conlact Person (Plan Roview) <br /> Descriplion of Work fo�o Done: _[�te'�lct�'- �/vn /y�Y' /��LN,�� �(�i(� g'�/r��f <br /> � <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 /> 1 hereby ceriily fhat 1 have read and examined this apf�lication and know tho same(o bo Wo and <br /> conect. All provisions o/la�vs and ordinances govwrunc�fhis f}�po ol work n-ill be completed <br /> whether speafied herein or noL The granfing o/a pomut does not rosumo fo�ive auU�or�ty to <br /> violale or cancel the provisions ol any ot0er stat�or local laiv rec�aPfing construction or the <br /> perfomiance o/construction. That I am aufho�ized by the owner o/this propeAy fo pedomi the <br /> mork!er�rhrch application is made and 1 comply wifh the State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ✓ <br /> '=--_ �, �� (/ ��� <br /> Slgnature Date I <br /> �(� <br />