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+ I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> /�-a 6-r 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C d�O�15 <br /> , / I <br /> � �.V�G' � � � �JC��f�'� l�.l , �j �� <br /> c�� P�. � Jc m � � <br /> PROJECT ADDRESS <br /> �� ' ��,���,� 2�06 P�=�,�,��r�9,. ���r�-fl��;�1, ��szo <br /> Owner ail Address Cily State/Zip Phone <br /> ,_..--------`-----_. . <br /> Tenanl Mail Address Ciry State/Zip Phone <br /> Electrical Contraclor Mail Address City Sta�e2ip Phonc <br /> Slate License Number Conlract Prico of Work <br /> Proposed Usc of Duilding Contacl Person (Plan Review) <br /> Descriplion of Work lo Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> [iE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf 1 have read and eaamined fhis application and know fhe same to 6e true and <br /> c�rrecL All provisions ol laws and ordinances govemmg this type oI a�orA will be complefed <br /> whefher specd�ed herein or noL The grantirg of a pernut does nof presume to give authonty to <br /> violafe or cancel lhe provisions olany other sfate or local lmv re�u/ating const�ucfion or fhe <br /> perfoimavice of construchon. Thaf 1 am authorized by fhe o�vner o/fh�s property fo pe�form fhe <br /> �rork lor which application is made and 1 comply wifh the State Con6actors Law 18.27 RCW and <br /> 29f.200 WAC. <br /> / , , ��� <br /> Signalure Date ��1�1.�v) <br /> V <br />