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f�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U CEDAR STREET, EVERETf, WA 98201 G,' `� S_D�'f <br /> 425-257-8810 - rlll: 425-257-8857 —www.everettwa.org � /I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM Tp 4 PM C O)O / `O`-� � <br /> a� a3 �m��� ���__ <br /> PROJECT ADDRESS <br /> S I��r r ie. YYI����ti� �•.1a3 Lernbav�� f�ve-� �v ere�}- l�� �1 �l8�� <br /> Owner Mail Address City Slate/Zip Phene <br /> �'�°�� :�� 2��'��ai� <br /> Tenant Mail Address City State2ip Phone <br /> �u�ner <br /> Electrical Conlreclor Mail Address Cily State/Zip Phone <br /> Slale License Number Contract Price of Work <br /> ��� ho�71� <br /> Proposed U �of Building Contact Person (Plan Review) <br /> Descrip�ion of Work l0 6o Done: ���p �,_��0��.� <br />�� <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, Iv1C OR AC CABL[. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE{S 3105 <br /> I heicby certi(y that I h:�ve read and ex�vnined fhis applicafion and know fhe same fo bo frue and <br /> co�recL All provrsions o//a�vs and ordinances goveming fhis fype of work u�ill be completed <br /> �vhefher spea/ied herein or noL The granting o(a permd does not presume to give au(honty fo <br /> violate or cancel the�rovisions oI any other stafe or local law regulafing consfruction or fhe <br /> perlormance ol conslrucfion. That I am authorized by fhe o�vnero/th�s property fo per(omi Ihe <br /> work Ior which applir,afion is rnade and 1 comply with the State Contractors Lew 1827 RCW and <br /> 296200 WAC. <br /> � �2��-r�' �� C'�S D `j � , � <br /> � Signature � Da�e �� <br />