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( I <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 TO 4 PM <br /> � <br /> �� � I 3 ��n�K� C�- a�� , , �p ! / /� <br /> PROJECT ADDRESS �'� '7'Z�`�p( <br /> � ��e- I�'� � ������ 'I���Z��`�d �1� q��� �°a 7 <br /> Owner Mail Address Gty Sfate/7Jp Phone <br /> � c:�( � <br /> Tenant Mai�neeress Ciry State/7Jp Phone <br /> ��J ✓t�c� <br /> Electrical ConVactor Mail Address City Slate2lp Phone <br /> Slale License Number Contract Price of Work <br /> -�a ��I�x5 <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: I `��� ����� 1 I ` � ��� M�-�'E�°� <br /> 1-� - �l� �w.;o 5��;� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 havo read and exemined ihis application and know the same to be true end ��l'� — OS� <br /> correct. All provisions u/laws and ordinences govemmg thls type of work will6e completed <br /> whefher sNea(ed herein or nof. The granting of a permit does nof presume to glve authority to <br /> violafe or cancel the provisions o/any otherstote orlocallaw reBuletlng construction orthe <br /> performance o/construction. That 1 am authorized by the owner of thls�roperty to perform the <br /> work/or which applicetion is made and 1 comply witlr the Sfafe Contractors Law 18.27 RCW and <br /> 296.200 W . <br /> � l � <br /> Signat f ate <br />