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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9E201 3 —a� -06 <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org � 06 03 � �b 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��ti �� ����b�„ � n„� r�,��.�.�-�- v�l� ��a► <br /> PROJECT ADDRESS <br /> �360� ��;_y,� <br /> (^r,��� .� ��,1n�II ti I�/)5�7 ���,;h Pr �/�ti 2�l Sf /�1�,�2,e�,�1//� `1�,���- <br /> Otvnef �— Mail Address Cily Slate/Zip Phone <br /> Tenant Mail Address City Stafe/Zip Phone <br /> Flectrical Conirac�or Mail Address City Stale/Zip Phone <br /> Stale License Number Contract Price of Work <br /> ��i f'Y.tS� n� <br /> Proposed Use o(Building Conlact Person (Plan Re�Jew) <br /> F� , <br /> V <br /> Descriplion of VVork to Be Done: � ���ti - � �1� <br /> �J <br /> �, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO f-EE <br /> iB� IN RACEWAYS, MC OR AC CABLE. SS I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily lhaf I frove read and ezamined fhis applicafion and know the sarne to be frue and �Gl� 0 �i-1(�3 <br /> r.orrecL All provisions ollaws and ordinances governing this(ype ol work�vill be completed <br /> whefher speafied herein or not The granfing o/a pemut does not resume to give aufhonty to <br /> violafe or cancel the provisiens oI any othe!state or local law reguPting construc6on or the <br /> perlormance olconstruchon. That I am auihorized by the o�vner o(th�s property to peAorrn the <br /> Kork Ior�vhich applicafion is made and 1 canpty uifh Ihe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. _ <br /> - �� v�� ��Li��` -���- .j � _Il.�-V V <br /> � Siqnature,::' � Date <br /> ._ J. <br />