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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25i-8810 - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> O �� � (� ��-�A-I ��- <br /> PROJECT ADDRESS y '�'s <br /> .�az <br /> Uu,����, Jz�u �� N M� �// �- � ���u {�!L ,Ec/ 9�Xo 3 / �-G o <br /> Owner Mail Address Ciry State/Zip Phone <br /> Tenant Mail Addmss City State/Zip �Zs' Phone <br /> ,�S'L-<F�u��M- ��c S �40/ !�� �V f�l! 1��e1 7s'y �/�% <br /> Eleclrical Conhactor � Mail AdJress City State/Zip Phone <br /> ���14 /V,l5/ y 2 � <br /> State License Number Contract Price of Work <br /> SF� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Dane: ��!'L/S-G� 1 �''u�L �y��ff� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �S- <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I hereGy certily fhat I have read and examined this application and hno�v the same fo 6e frue and <br /> conect. All piovisions olla�vs and ordinances governmg Ihis lype oI�vork will be cornp/efed <br /> u-hether specified herein or noL Th�granting oI a pemuf does not presume to give authonty to <br /> violate or cancel Uie vovisions o/any other sfate or local law regulafinq construcfion or fhe <br /> peAomiance olcons�ruction. That 1 am aufhorized by the owner o/tf�is prepmiy to peAorm fhe <br /> work lor which applicafion is made and 1 compty with the State Contraclors Law 18.27 RCW and <br /> 296200 WAC. <br /> ,��� �o y � ,� <br /> ignaWre ate <br /> / <br /> ���-�J �v�-� � <br />