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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIY 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 /> (0 �3. � • `�� . �F oln _e � <br /> PROJECT ADDRESS <br /> T�[ � l� !`IamCa+'� /ar�� \ L�' � �- Y�,�• ��iOAi� �,�C� � va53.53-� 0 <br /> Owner �_ Mail Address � City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �por tl��n � ��30 4 ,j, r�, .+-r�.��D�S�to�lom n�\• wa �]Rl�� 4a5�131 03�� <br /> EleCtrical ConhaCtOr Mail Address City State/Zip Phone <br /> /�0�'1 e� �/fs'6Q��' <br /> State License Number Contract Price of Work <br /> Proposed Use of Building . Contact Person (Plan Review) <br /> Description of iNork to Be Done: �;�,J! 0 .'�I p�• <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC ORAC CABLE. <br /> CITY GF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> 1 hereby certi/y that 1 have read and examined this application and know the same to be true and <br /> correct All pmvisions o(laws and ordinances govermng thrs type o/work will be completed <br /> whefher specified herein or not The granting o/a permd does not presume to give authonty to <br /> violate or cancel the provisions of any other sfate or local law regulating construction or the <br /> pe6ormance o(construcGon. That 1 am authonzed by the owner o/this property to peAorm tf�e <br /> work lor which application is made and I comply with fhe State Contrec(ors Law 18,27 RCW and <br /> 296.200 WAC. <br /> `_' � _ �.0.�in � 9 d � �� 1S <br /> Signature �e n/�� <br /> U/(/ <br />