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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 /> ��� 7 z rY ����� <br /> PROJECT ADDRESS <br /> �l1i�11�,> lLt, l��r.�_ f�o /�ny l� c.�o � j �zolv �fz.r_��z z ��� <br /> OWner Atail Address Cily Stale2lp Phone <br /> Tenanl Mail Address City Slate/Zip Phone <br /> Eleclrical Contraclor ?.fail Address City Slate2ip Phone <br /> Slate License Number Conlract Prico of Work <br /> I�-�L[�-� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion o(Work lo Do Done: �/r'�-c� /�L � ��r.> I l�`�� �t'!�-G <br /> NOTE: WIRING ItJ NON-DWELI.INGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhaf 1 have read and exomined O�is applicafion and know fhe same to 6e truo and <br /> correcL All provisions o(/aws end oidinances govoming fhis type ol work will bo completed <br /> whether spea�ed herein cr noL �he�ranfing of a pennd does not presume fo gi��s authonty to <br /> violate orcancel the provisions ul eny„ther state orlocallaw rec�ulafing construction or fhe <br /> peAomiance o/construcfion. 7hnf 1 am aufhonzed by the otrner o/this property fo perfortn Ihe <br /> work Ior�vhich applicaticn is mado and 1 comply�vith the State Contrecrors La�v 18.27 RCW end <br /> 29G 200 WAC. <br /> / /3 <br /> , � t7 , , <br /> ; , , <br /> � �,� t � �t . <br /> Siynaw e � � Date �- �i � . <br /> � <br />