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a <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES -�3� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 , ;� ' <br /> 425-257-8810 - FAX 425-257-8857 -wvuw.everettwa.org 6 � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /-��; �;%���;;� C�,� w.�� :, �i��� 9 <br /> PROJECT ADDRESS ' <br /> �C� �l� v �� . _ <br /> Owner Mail Address City Slate2ip Phone <br /> Tenanl Mail Address City Stale2ip Phone <br /> //����IC/�.oi iGCt'C� ���QhJ �5J% �/� �i�ro�4 7Jt'O�f� J/-.:�0 � .��� lo <br /> Electrical Contraclo Mail Address Cily Slate/Zip Phone <br /> J <br /> `1YI�°.��iJ G i�� r��� � �o°� <br /> State License Number Contract Price ot Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> d �' <br /> Description o(Work lo Be Done: �l�D�/�,1 , /��'�G /iiu�f'iG <br /> �7—�— <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 here6y cerlily fhat 1 have read and examined fhis applicafion and know fhe same to be true and <br /> correcl. All provisions ollaws and ordinances govemirg fhis type ol work H�ill 6e completed <br /> whether spealied herein or noL The granling o/a pernuf does nof�resume fo give aufhonty to <br /> violate or cancel fhe provisions of any other state or local law regulating consWction or the <br /> periormance o/consfniclion. That I arn aufhorized by fhe o�wiero/this property fo pedomt Ihe <br /> wak lor�vhich application is made and 1 comply wifh fhe Sfafe Confractors Law 1827 RC W and <br /> 296.200 WAC. <br /> / . j � �� _�. ,�'��-D � <br /> Signature Date <br /> n � � <br /> - ���� <br />