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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /,�_7 �O� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org 6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (r06 o'g a�z <br /> �! �� � ��I'��� � �� <br /> PROJ CT ADDRESS <br /> �/lF�z�/ �►� � � l-2d��,;� � � 1�: ��) /a.� l Son/ U,� A� w �l � ��-i�1c - ay <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mall Address City State2ip Phone <br /> EIBCtricalContractor MaiiAddress Ciry SWte2ip Phon< <br /> Stale License Number Conlract Price of Work <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: � ��Loti�.L. C�G� �NOnt _ / N.l C)�� <br /> .�' <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 /> /here6y cerfily fhaf 1 have read and exominod fhis applicafion and know the same to be frue and <br /> correct. All provisions o(laws and ordinances goveming this type o!work will be completed <br /> whefher specified herern or not. The granfing of a pennd does nof presume to give aufhonty to <br /> violate or cancel fho provisions ol any other sfate or local law regulafing construction or the <br /> perlormance o/constnufion. Thaf 1 am authonzed by the owner o/this property to peAomi the <br /> work lor�vhich application is made and 1 comply with the Stafe Contractors Law 18.27 RC W and <br /> �.296.200 WAC. <br /> '� �-' — ° `��°7� � 6 <br /> ignalure Dale � <br /> � c�c� &� �' 3 � <br />