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f <br /> 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.everPttwa.org ,` `� `�-� <br /> .,� �APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �' ����(,� <br /> �_S/� �.LG � ���� -- <br /> PROJECT ADD ESS <br /> I PU�� �}��,,�,� <br /> Ovmer Mall Address CNy State2ip Phone <br /> Tenanl MailAddiass Clty Stete2fp �hone <br /> � �.Yv S <br /> �iN.�'� C/ll��e. C�7Nt !/d�.f 1�� �i�rinr5 ��v ��l d�c� <br /> EleCtriC31 ContraCtor Mall Address CNy State2ip Phone <br /> �i�ith�c fj i�,� �P� �57� '� <br /> State Licensa Number Contred Price ot Work <br /> .�,,,-! �'�Y <br /> Proposed Use of Building � Contad Pereon (Plan Review1 <br /> /[/i�[L �G/i!�//E'�Ci ��� <br /> Description o/Work to Be Done: —. --- <br /> NOTE: WIRING IN NON•DWELLiNGS IS REQUIRED TO <br /> BE IN RACEWAYS, MC OR AC CABLE. �j� vO <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�106 <br /> 1 hereby certiry thaf I have read and examined this epplicafion and know fhe same to be true and � I��� I�� <br /> correct A!I provisions o/laws and ordrnances goveming Ilus type o/woiic will be,complefed <br /> whefher speci(red Aerem or noL The granting ol a permrt does nof presume fo give authonty to <br /> violate or cancel fhe p�visions olany olher sfafe c local law regula(ing construcfion or thP <br /> perlomiance ol c nstruction. That I am ainhonzed oy fhe o�+�ner ol this pmperty fo peAorm the <br /> wo�k lor which a plication is made and 1 compty wi(h the Stafe Confracrors Law 78.27 RCW and <br /> 296.200 WAC. G� , / <br /> i / <br /> � f(r%7�— <br /> Signature Date <br />