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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 —wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> %l� ��In12 �✓ �IJ'v- zVa��n W� �f�-°� <br /> PROJECT ADDRESS <br /> C�p�J� �z�{u � l°�2co Mz,��ol,� u.�,¢v� ��f-� 1��9- �r��a� �4z3"��lar� <br /> Owner C Mail Address City SlalelZip Phone <br /> Tenanl Mail Address City State/Zip Phone <br /> Eleclrical Conlraclor Mail Address Ciry StatelZip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: � \�L�� `�'`'�� � ���� Sc:,���- <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 fliaf 1 have read and examined fhis applicafion and know the same to 6e true and �. J <br /> conecl. All provisions o/laws and ordinances goveming fhis type of work will be.complefed �O p �� �G � <br /> whether speafied herein or nof. The grenting o(a permif dces not presume to give authonty to <br /> violate or cancel the Provisions o/any other state or local law regulating consfruction or the <br /> peNormance ol constiuction. That I am authorized by the owner of fh�s property to per(orm the <br /> work(or which application is made and I comply wifh the State Contracfors Law 18.27 RC W and <br /> 296.200 WAC. <br /> ,� l o �'�-o� <br /> Signature Date <br />