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� <br /> � <br /> ELECTRICAL PERMIT APPLICA�'ION <br /> CITY OF EVERET`i 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 /> � 3� � L`- /Y�a��..z. l/� (�� . `�� r <br /> PROJECT ADDRESS <br /> �(8��- I ( �Clt �L✓Vr <br /> �t l�?C�d-� �s7c�� _ �>(c�SSr1�J ,�r2��/fiU� �f//�- �hDS� <br /> Ownef MaH Address City State/Zip Phone <br /> Tenanl Mail Address City Slate2lp Phone <br /> Elec�rical Conlraclor Atail Address City Slate/Zip Phone <br /> Slato Liconse Number Conlract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Reviow) <br /> Descriplion o(Work to Bo Done: � ����– ` �� �-1 <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 1 have read and exemined fhis app/ic�tion and know fhe same to be frue and <br /> correct. All provisions olla�vs and ordinances�ovemmg fhis type o/�rork�vill bo cornpleted <br /> whefher specilied herein or noL Tho granting of a pemuf does not presume to give authonty fo <br /> violnfe or cancel(he provisions ol any other state or local la�v regu/nting censtruction or tho <br /> perlonnance ol consfniction. Thnt 1 am authodzed by fhe o�vner o/fhis propeAy fo pedorm fhe <br /> �sork Ior�vhich applicafion is rnade and I cornply with the State Confractors Law 18.27 RCW and <br /> 296.200_WAC. <br /> �z•��� z/ � „ <br /> � Signature Date —� <br /> �lU(o l Z -U7� <br />