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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 �y`/ <br /> 425-257-8810 - FAX 425-257-8857 -www.evereftv�:a.org 1��5 J S � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�i PM <br /> ��D/ � //� /'.L�f�/��� l�iJ%� <br /> PROJECT ADDRESS <br /> i' G ,c��� �°P <br /> Owner Mail Address Ciry State2ip Phone <br /> Ten�nl Mail Address Cily Slale/Zip Phone <br /> 1�'1���a� � /��� ����� �a�J���� �,s ���o ,�9�o�e ���'���7��� <br /> Eleclrical Coniractor Mail Address City Slate2ip Phone <br /> ��l �° ,� %n/E 1/O � � 6 ���a � <br /> State License Number Contrecl Price of Work <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description o(Work to Be Done: OS�C � �� � n �'w �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat 1 have read and examined Ihis application and know fhe same to be Vue and <br /> correcL All provisions ollaws and ordinances goveming fhis type ol work will be completed <br /> whefher speciGed herein or noL The granfing of a pernut does not resume to give aufhonq�to <br /> violate or cancel Ihe�rovisions ol any ofher sfate or local law reguPting consfnution or the <br /> perfonnance o/construcfion. That 1 am aufhonzed by the owner o/this property fo peAonn(he <br /> work Ior which app cafion is made and 1 cpmply wifh the Sfafe Coniractors Law 18.27 RCW and <br /> 29 200 WAC. �/ <br /> �l���u. � / �` ������ <br /> 5 naWre / Date /' <br /> / <br /> ; ���`,-1 l�7 <br />