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i��s � <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 � ��O � �6.`y <br /> ,/�915 /'��l�i,ulLD�s �tJl�l�'�f L-r//`'{ <br /> PROJECT ADDRESS <br /> J.>c'� � 4'��sc-�� ����1<<�10/ Git��i�� � �� lr��t' 93.35G �Cd-��/_T 5T <br /> OWner Mail Address City Slate/Zip Phone <br /> Tenanl Mail Address City Slate/Zip Phone <br /> Electrical Conlraclor Mail Address Cily State/Zip Phone <br /> Slale License Number Contract Price of Work <br /> �.�i�, ic/ �( l"��1 i» . �y /�/ r <br /> Propos�bse of Building �— Contact Person (Plan Review) <br /> Description of Work to Be Done: � �� n !J/� t'�L <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily Ihaf I have read and examined fhis applicafion and know the same fo be true. and � GIFiJCi-p�y <br /> co�recL All provisions ollaws and ordinances governmg this type of work will be completed <br /> �vhefher speafied herain or noL The c�ranting o/a pennd does not presurne to give authority to <br /> violafe or cancel the piovisions o/any other sfale or local law regulafing construcfion or the <br /> pe�lonnance o(construcfion. That 1 am aufhorized by fhe o�vner o(fh�s property to perform fhe <br /> work!or�vhich application is nmde and 1 cornpty wi(h Ihe Slate Con(racfors Law /8.27 RCW and <br /> 29G.200 WAC. <br /> :� ' • <br /> ��� � <br /> Sigdatur Date <br />