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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 /> -'S �- 7 �Lt l �7Q�� �� � v.�rl�/� 1� ��`'— �� <br /> FROJECT ADDRESS <br /> �/zs`—yz z-�5i Z <br /> 1zc�oZ <br /> �)�Gy� f 22� l�� �D (�D v �1 c�Cr�� �= l��U�r. G� av'� �! ���� i <br /> � <br /> Owner Mail Addross Gty Slate2ip Phone <br /> Tenant Atail Address Cily StatelZip Phonc <br /> Eleclrical Conlractor Atail Address City State2ip Phone <br /> Slate License Number Conlract Price of WorY. <br /> �J <br /> .� a4�� _ <br /> Proposed Use o(Building Conlacl Person (Plan Review) <br /> Descriplion o(Work lo Do Dona: �I� , / �4 tflr�r �� ���! c.� � -+ <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 /> 1 hereby certily that!have read and examined this applicafion and know fhe same fo be truo ana <br /> correct. All provisions o/laws and ordinances goveming fhis type of n�ork will be completed <br /> whether specified herein or not The granting of a pemid does not resume fo give authonty fo <br /> violate or cancel tho Provisions o/any other sfate orlocallaw reguPting consf�ucfion or fhe <br /> perfomiance ol construction. That 1 am authonzed b}�fhe o�rner o/fhis propeAy fo pedomi Ihe <br /> �ti�ork lor which applicafion is mado and 1 cornpty wifh fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��.c�_ �vL'� �����'� <br /> Signature Dale / <br /> �,,;. � � <br />