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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��`ll <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C3'%� ��DOS <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-}2(�Q 2;ay r��en�- I-G7. � �VERE Ft� W� �1�i 7U 3 <br /> PROJECT ADDRESS <br /> �iZC—C� U"�ZG�V�C.L y�� 2j� �zii�n:T �r . ���CN � '`i c�� 3 <br /> Owner Mall Address City Slate/Zip ?hone <br /> Tenant Mal�Address Cily SWIe/Zip Phone <br /> SIJa�Y�U7'tii ��� ��LC�� ��W T1 sh� �� <br /> EleClriCal Conlraclo� Mail Address Gry Stale/Zip Phone <br /> State License Number Contracl Price of Work <br /> Proposed Use of Bullding Contact Person (Plan Review) <br /> Description of Work to Be Done: <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 /> I hereby certify thaf I have�ead and examined this application and know fhe same to be true and <br /> correct. All provis7ons ollaws and ordinances goveming this type ol worlc will be completed <br /> whefher specified herein or not The granfing ol a permd does not�resume 1�give authonfy to <br /> violafe or cancel fhe provisions oI any other stafe or local law regulating construction or the <br /> performance of construcfion. Tliat 1 am aufhorized by the owner o/this property to perlom�fhe <br /> work lor which application is made and I comply with the Sfate Contrec(ors Law 18.27 RC W and / <br /> 296.2��WAG � q pU� <br /> � _ <br /> � � 3-3i-�� � �I b <br /> Signal ,./ Date <br /> 1 <br />