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I ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S- ab -�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �/ S "I � <br /> 42�-257-8810 - FAX 425-257-8857 —www.everettwa.org � 06 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -�� Jl� ��c���-Ne �� <br /> PROJECT ADDRESS <br /> ��� ' � � �c� /O ��CX w�e-i/ _u�FP`� Lv I�- ���/ <br /> Owner Mail Address Cily Slale2ip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> �Oc�J��� � ��c_`Crcc <br /> Electrical Co�lractor Mail Address City StateiZip Phone <br /> l <br /> Slale License Number Conlracl Price of Work <br /> �(�c /�c'C�-tl�C <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> GITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I hace read and exarnined fhis application and know fhe same fo Ge We and <br /> conecf. Al/provisions o/laws and ordinances c�overnmg tf�is type ol work will be complefed <br /> whefher specilied he�cin or not The granfing o(a pemut does not resume to give autlionty to <br /> violate or cancel the r�rovisions o/any oU�er state or local law reguPfing construc6on or the <br /> performance o/consfruction. That 1 am aufhonzed by fhe owner o/Ihis property fo peAomi fhe <br /> work lor which application is made and 1 comply with the Stafe Contractors La�v i8.27 RCW and <br /> 296.200 INAC. <br /> � ,<� � � <br /> �,., =�-� ;,��p � � - ?(; -U6 <br /> �ignalurc Date <br />