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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 /> � ���- Fol2C�'T UrL <br /> PROJECT ADDRESS <br /> C/�',�2/ s�Lf/)/� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address Cily State/Zip Phone <br /> /�-f `�i!� %�/ �CL(=C.%/Z/ � <br /> EleCtrical COMractor Mail Address City State/Zip Phone <br /> /��( � G if.a �= c. c� a 3 iJ� <br /> Slate License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: Gv 1��� �j UJJ/1 /0/l� (,�i'��ti�0l�� — b�/j njl'S�/�() <br /> C)l�V �/�ru ,��_' !>1-%[=LiL-/LS <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> 3� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby certi(y fhat 1 have read uad examined fhis application and know the same to be true ar;d <br /> correcL All provisions of/aws and ordinanr.es goveming this type of work will be completed <br /> whether speci�ed herein or noL The granting of a penn�t does not presume to give aufhonty fo <br /> violale or cancel the provisions o(any other sfate or local law regulating construction or the <br /> perfonnance o!consfruction. That 1 am authoiized by the owner o/this property to pe�iorm fhe <br /> work lor which app/icafion is made and 1 comply with fhe State Con6actors Law 18.27 RCW and <br /> 296.200 W.4C. <br /> /"����� //— / � � � <br /> Signa ure�f7 Date � <br /> / <br /> f� �1/ ' �� <br />