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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 AM TO 4 PM <br /> /0/ 35` m ��2 � ���- •v � "� <br /> PROJECT ADDRESS <br /> /�f/r¢�U �/ l�a �✓� T�C v � T�u .-�/ <br /> Owner Mail Address City StalelZip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �✓��.�--�: �GGTC./ .��� � sy s�.� :.� � J T c���o-J�s 9flo� �. <br /> Eleclrical Conlraclor Mail ACdress City SWIe/Zip Phone <br /> �fLJ- 77y- s,sz3o <br /> � u .�. .2�T�-I�':�'y/<F <br /> Slale License Number Contract Frice of Work <br /> S .F � <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion o(Work to Be Done: /Q ���'e Lr �— /���.✓ S. � � <br /> i9•✓� L,o ..,r v�a �T•9�-c'— <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 fhat 1 have read and examined Ihis applicafion and know fhe same to be true and <br /> correcL All piovisions ol la�vs and ordinances governing fhis type oI work will be completed <br /> whefher specdied herein or noL The granfing o/a pernut does nof resume fo give aufhonty fo <br /> violafe or cancel fhe provisions olany ofher state orlocallaw reguPfing construcfion or the <br /> peiformance oI construchon. That 1 arn authonzed by the o�vner ol fhis property fo peAorrn the <br /> �vork(or�vlrich applicafion is made and 1 comply with fhe Sfafe Contraclors Law 18.27 RCW and <br /> 296.200 LI�AC. <br /> o,_-�.�� �_ Z I l (o � l�.�7 <br /> SignaWre Date <br /> �p• �i..l _ !�Y <br />