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1 <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 /> ���� z ��/�,ri �%a � <br /> PROJECT ADDRESS <br /> yZ1 ��/U Vf 1 <br /> .�/i>» r� �iC'/s�� //2i 7 3 i��' D�f St`- ��/c7'Lc�Tl c�/r!� ��d2�� <br /> Ownef— Mail Address Cily State2ip Phone <br /> Tenanl A4ail Address City Slate2ip Phone <br /> Eleclrical C�lraclor A1ail Address City State2ip Phone <br /> Slale License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Revie�v) <br /> Descriplion of Work lo Be Dane: U(1 Vct,(.� — W� �� � �� c�V� � PQi�� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY UF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and exarnined fhis applicafion and know the snme to be tn�e and U � �,"V <br /> co�recL All provisions ollaws and ordinances goveming this type of�vork«�ill be complefed F 1\� <br /> �vhefher specr6ed herein or not The c�rantinr�oI a pernut does nof resume to give aufhonty to <br /> violate or cancel fhe Provisions o(any other state or local law re�uP(in�consfruction or the <br /> perlonnance o/conslrucfion. Thaf 1 arn authorized by fhe owner o/this propeRy to pe�lorm the <br /> w•ork Ior which pplication is made and 1 comp/y with fhe Sfafe Confracfors Law 18.27 RC:N and <br /> 296.20D WAC / <br /> / /J <br /> I^���_ �/C "� �(J / 2 � , <br /> SignaWre � Date <br /> I <br />