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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 /> ! /1 - L � <br /> %� �i � � 7��.=1�t/� <br /> PROJECT ADDRESS <br /> S��(�f��I ti�l � ��71,�C"�/���gG���cl ��.�e�C � <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenanl A1ail Addross City Slate/Zip Phonc <br /> .� /�// �7/� J�n�-r <br /> v.f v <br /> E eclric0l Contractor Wail Address Cily Slate�2ip Phone <br /> State icensc Number Contrect Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion o(Work lo Be Donc; /�.���G� ��"'<<��`-� �' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y fhat I hare�and nnd exaunined fhis applicotion nnd know the sarne to be truo mid <br /> conecL All provisions of laws and ordinancos governuig fhis fype of work will bo complefed <br /> �rhether spcafied herein or no( The grantint�ol a pennit does nof presume to give aufhonty fo <br /> violate or cencol th^r�rorisions any ofher stafo or local law ragulafing consfrucfion orthe <br /> peiformance 01 construcfion. Th t 1 nnl t�ufho�ized by fhe o�vner ol ihis propeAy fo pertortn the <br /> �vork lo��roliich applicntion is m and l.comply wifh the Sfate Contrncfors Lew 18.27 RCW and <br /> 296.2001NAC. / O� <br /> �- � � '- /0/- <br /> � �`{ ����z; /� i �_ i� <br /> �Sipnalu `_� Date <br />