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_�, -- <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 -•,vww.everettwa.org 7-01��0 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C�7���`3/ <br /> -� <br /> � <br /> � ^��2� �. 9 <br /> PROJECT ADDRESS / <br /> Ownef Mail Address Cify Slate/Zip Phone <br /> �.�� �/rc[ �� � ��r� <br /> Tenant Mail Address City State/Zip GG Phc�e <br /> . ( I,.. � �� � <br /> lc,�,�c< <�����-��- ►-�c l ���'c� � ll �'�`'' ���c Ni� � (u��� �r,� �4�z'� <br /> Electrical Conlraclor t�7ail Address City StateiZip Phone <br /> ' .� c. .�L-"I � _ <br /> Stale License Number , ontract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> / I 1 ---� <br /> Descripiion of Work to E.e Done: ( l �2�! G � � <br />_� <br /> NOTE: WIRING IN NON-DWELLINGS IS RCQUIRED TO FEE <br /> BE IN RACEWAYS, A4C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y ceitily that/have�ead and examined fhis application and know fhe same fo be true an� <br /> co�recL All provisions ollaws and ordinances governing Ihis type o��vork will be completed <br /> whether speci6ed herein or noL The�ranfing of a pemu(does nut resume to give authority to <br /> violate or cancel the provisions o/any other sfafe or local law reguPting consWction or the <br /> performance ol consfruc6on. That 1 am au(horized by the owner o/this property to perform the <br /> work/or which application is made and 1 complv with fhe Stafe Confractors Law 18.27 RCIN and <br /> 296.200 WAC. <br /> _ � <br /> � � - � - �-� ; <br /> ,' . - _- ,, -) �',,'�' �% <br /> , _ , y � �- <br /> � <br /> Sign,ture _ `!� Date <br /> - ----T - F��o7-�3q <br /> � <br />