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t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 5 —� —/0 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � ��� S—�U� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /��% �7 7 f�-��� �- - ,`i% <br /> PROJECT ADDRESS <br /> �y�ti ���.�'� <br /> Owner tdail Addross Ciry State/Zip Phone <br /> Tenanl Mail Address City Slate/Zip Phono <br /> Electrical Coniractor Mail Address City State/Zip Phone <br /> Stalo License Number Coatract Price of Work <br /> Proposed Uso o(Building Conlacl Person (Plan Reviow) <br /> Doscriplion of Work to�c Dona .0=���! / ✓ `l � fL� O�z � 1 <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 '� <br /> 1 hereby ce�iily that I fiavo read nnd examined Ihis applicnlion and know fhe same lo bo fruo and �% <br /> cunecL All piovisions olla�vs and ordinances goveming this typo ola�ork�vill be cornplefed �� <br /> whether spealied herein or not The�ranting ol n perrnd does not �resumo fo give authonfy to � <br /> violafe or cancel the provisions oI any ofher sfate or local la�v regulnfing consfrucfion or fhe I �� <br /> pedonnance o/construcfion. That 1 am aufhorized by the owner o/fhis property to pe�form fhe � !( �- <br /> tvork/or which applicntion is rnado and I cornpty�vifh fhe Sfato Confractors Law 18.27 RCW and <br /> 296.200 WAC. ---� <br /> _ - -- 3 '/ <br /> _�__-! < <br /> _ L—� �' G���� J ;� y ��� <br /> Signature DatA - <br />