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t� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ,`�7�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> �0 6 0 � --�3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> —� `{�6 S �c,;,�,,o� <br /> PROJECT ADDRES�S <br /> I-1A �-.�����(c r- N I�o /S �� m r� ni SaiJ til � V � ✓i✓n//�✓� 2a �-7yD -so a <br /> Owner T Mail Address City S ate2ip ct G�3� Phone <br /> 0 <br /> Tenant � Mail Address City State2ip Phone <br /> Electrical Contractor Mail Address Cily State2ip Phone <br /> State License Numher Contract Price ot Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> � <br /> Description of Work to Be Done: � . �� �-p'�^i/> �✓✓S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have read and examined this applicafion and know the same to be frue and <br /> correct. All provisions ollaws and ordinances c�oveming this iype o/work will be complefed <br /> whether spea6ed herein or noL The granfing o/a permd does not presume fo give aufhority to <br /> violafe or cancel fhe provisions ol any other stafe or lucal law regulafing consfn�cfion or the <br /> perforrnance o/construction. Thaf 1 am aufhonzed by fhe owner c/fhis property to peAorm the <br /> work lor which application is made and 1 comply with fhe Sfate Contracfors Law 18.27 RCW and <br /> 296,200 WAC. <br /> p ' d � <br /> � ignature Da1e <br /> `—% F of�of� o$r3 <br />