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\ <br /> 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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �t..� �P;,�� S-r <br /> PROJECT ADDRESS <br /> ��� I,� ; �J��. I I��,� 3�� �, � E��r�-fil— C._) h �i'y o��0�- Y�ti � <br /> Ownef Mail Addross City Stale2ip Phone <br /> Tenanl Mail Addrass Cily Stale/Zip Phone <br /> �,k EI_�-n� �-`�� ,�I��-u� �� �q�1�..,,�l� (,J/�- `1 b'ali� , •tit.8-.� <br /> Eleclrical Contractor Mail Address Cllv Slate/Zip Phcne <br /> /�' 'I�� �'jln5 ,n (� �" �< <br /> Stale License Number Contracl Price of Work <br /> Pro osed Use of Building Conlacl Porson (Plan Review) <br /> Description of Wark lo Do Dona: ,�,y2_` "�2.'�-qc�� (.J � .�'�'� ' .�V�o��_r-s <br /> NOTE: WIRING Iv NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �V�. , � �� <br /> 1 hereGy ccriify thaf 1 bave rend and exnmined this applicntion and know the same to 6e fruo and <br /> correcL All provisions of la�vs and orclinances govemmg this fype ol work will be completed <br /> whether spea�ed herein or noL The grenting o(a perrnR does nof rosume fo give authonty to <br /> viola(e or cancel tlie provisions of any other sfate or local law reguPting conslrucfion or the <br /> pedomiance o/ca�strucfion. Thaf 1 am euthonzed b}�fho owner o/fhis property to pedomi the <br /> work lor whi�,lrapplicafion is mado nd I compty with fhe State Contrac(ors Law 18.27 RCW and <br /> 296.200 A . <br /> 7- - o <br /> Signatu � Date <br />