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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–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� 2/ ���} �14'-/ '�!� <br /> /�`�J� �RE 6 iviEl Sj'J — <br /> u+✓ <br /> %�i�P�l7�J LC� .i3/3 �E /9Bni � �� Gvi�I" J�/S� �337 <br /> Owner Mail Address City Stata/Zip Phone <br /> Tenanl Mail Address City State2ip Phone <br /> Dr,�,f� <br /> ''—'—"' Stete2lp Phone <br /> Electrical Contrador Mail Address ��Y <br /> State License Number Contract Prica,of Work <br /> Propos��e Building Contact Person (Plan Review) <br /> Squere Footage(If residenlial new construction, remodel or addit(on) <br /> Description of Work to Be Done: /���' �'�"��"–'C� " ��` ' " " <br /> �SI��Eic/G� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIT�'OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 h�,reby ceRily that I have read and examined this application and know the same fo be frue and �`��' _(�S <br /> correcL All provisions ollaws and oNinances goveming this type of woric will6e complefed <br /> whether specified herein ornot The granting o/a peimit does notpresume to give authority to <br /> viol:.te or cancel the provisfons of any other state orlocal!aw reguleNng cronshucfion orthe <br /> performance of construction. Thaf I am authorized by fhe owner o/thlsproperty to perlorm the <br /> work for which applicaHon is made and I comply wifh the Sfate Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �� <br /> Signa Da e <br /> �/���. ` . �,2, OuSn/�R- ��_ <br />