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1 <br /> 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.everet�wa.org <br /> APPLICATIONS ARE ACCEPTED f'ROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> .��'` ���r�/ u�._n �/�'�,��i, lr,%,9� ���v � <br /> f�ROJECT ADDRESS � <br /> / <br /> „i, � -���� ,� � � r,, � � <br /> Owner ,/ Mail Addrass Clty State2lp Phone <br /> � ,��' ��s 3SSa�a � <br /> Tenent Mail Addresa Clry State2lp Phone �I <br /> D U/!�/� <br /> Eleclrical ConUactor Mall Add�ess Clry Stato2lp Phone <br /> Stale License Number Conlract Price ot Work <br /> Pro�d Use o� Conlact PEreon (Plen P.evlew) <br /> Desc�Iption of Work to Be Done: �'���I?G� �'//`'i �b ���d,��l /,��%� <br /> ��X. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREO TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAI(COOE IS 3105 <br /> I hereby certily fhat I have read end exemined fhls eppNcatfon and know fhe same fo 6e frue and <br /> correcf. All provisions o/laws end ordinences goveming Ihls fype ol work wfl�be completed <br /> whether specilied herein or nof. The grentlng al a permlf does nof presume to glve aufhority fo <br /> violate or cancel fhe provisions ol any ofher slafe or locel law reguleting conslnrcfion or the <br /> perlormence ol construcfion. Thef 1 em euthorized by fhe owner ol thls property fo pe�lorm:he <br /> work lor which applicettan is made enA 1 comply wifh fhe Sfafe Contractors Lew /8.27 RCW end <br /> 296.2 O WAC. <br /> �' �7�' �'� <br /> 'f�:y',l,(;�� �� ��P�l��,� <br /> Signalure � Date <br /> �050�-�5 6 <br />