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l <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 /> APPLICATI�NS ARE ACCEPTED FROM B AM TO 4 PM <br /> �7 G c9 �rlJ� 6 � _L����4 „�— <br /> PROJECT ADDRESS <br /> S �,�,� ��25 330 1 SZ � <br /> �� 7G � ��'��� � l.� a 3 <br /> �? �� G U ,� � � �- � 4�a <br /> OWner Mail ddress City State2ip Phone <br /> Tenant Mail Adaress Ci�y Stale/Zip Phone <br /> ��Y�^�- <br /> Elecirical Contrector Mai�Address City S�ate2ip Fhone <br /> Slate License Number Contract Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description of Work l0 6e Done: C � /)��C SC'..✓CC�<<P � ._ <br /> Y <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby rerti(y fhaf 1 have read and examined this applicafion and kno�r the same to be fnie and C�i �O—�� <br /> correct. All provisfais ollaws and ordinances govoming this type of work will be complefed <br /> whefher specilied herein or noL The granting ol a permd does not resumo to give aufhonty to <br /> violafe or cancel tlie Provisions of an}�other state or locol law reguPfing construcfion or the <br /> peAomiance o/construcfion. Thaf 1 am euthorized by the ownero(this�roperty to perfomi the <br /> work for which application is rnado and 1 comply ivifh!he Stafe Contracfors La�+�18.27 RCW and <br /> 296.200 WAC. <br /> L .� CU. � • � <br /> Signalure Date <br />