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9 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www:everettwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �d�r[- t=l��-�.� , � , L., �� <br /> PROJECT ADDRESS <br /> ' //" � �GL��.Q �'I �` F�UL' c�« � �fi' 1U�5(f y[/� t'� 'J <br /> Owner Mail Address City Stale2lp Phone <br /> Tenant Mail Address City State/Zip Phone <br /> -'II�" �w•n��c' - <br /> EleClrical ContraCtof Mail Address City Stale/Zip Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Bc Done: �'�o� ��� hC' ���C� IVl t�V�'� ���� �i� � ��'�L""'" y <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have read and examined this application and know the same to be true and <br /> correct. All provisions o(laws and ordinances goveming this type e/work will be completed <br /> whether specified herein or not The granting of a pernut does not presume to give authunty to <br /> violate or cancel fhe provisions of any other state or Iecal law regu/ating consfruction or tho <br /> perfomiance oI consfruction. That I am authonzed by the owner of this property to pedorm the <br /> work lor which application is made and I compty with fhe State Confractors Law 18.27 RCW and �/�� _ �� <br /> 296.200 WAC. �i, '1 <br /> V✓ <br /> ,. �� <br /> �771�G la- / a[,c cy ,��-J T- 1 J <br /> Signa�ure Date <br />