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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 r�� <br /> �y� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��0 � //� ��/�� C�l1/� f K���/ /J�/�io��� <br /> PROJECT ADDRESS � <br /> `i` .(�/�J �� <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address City Slate2ip Phone <br /> �) � <br /> � �°��oA � /� �i��� �s��%� .J �/.�>,e �a/s �Po.�� '�-�-�,� 7i� <br /> , <br /> Electrical Contraclor Mail Address Cily State2ip Phone <br /> �// �h ' /VG � �� / �!� � dC� B/ <br /> Slate License Number Contrect Price of Work <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: C�D� �^-a G � /� ���piL- <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 that I have iead and examined this applicafion and know th�same to 6e true and <br /> correcl. All provisions ol laws and ordinances goveming tbs type o/work will be completed <br /> whether specdied herein or noL The gianling o/a pernuf does not resume fo give authonty fo <br /> vio/afe or cancel the provisions ol any other state or local law reguPting cons6uction or the <br /> per(ormance o(construcUon. That 1 am aufhonzed by the owner ol fhis property to peAomi the <br /> work/or a�hich application is made and I compJyyy�vith the Stafe Confractors Law 18.27 RCW and <br /> 29G.200 WAC. � <br /> ���,� � . <br /> ,� �s�� � �� �� �� <br /> Si ature Date I � n <br /> % �� IX <br /> �U <br />