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, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 � '�AR STREET, EVERETT, WA 98201 <br /> 425-257-881 u - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM G AM TO 4 PM <br /> � ZI 7�Ic��=��1c2 ��e��r �r� �1 �z� � <br /> PROJECT ADDRESS <br /> Sn�'����� S�:�/oo�� Z Z�z 7�c��,-c��C� ���2��� l�� I�l�l �yzs�s�-vGzG <br /> Owner Mail Address Gty Stale2lp Phone <br /> _. <br /> Tenanl Mail Aodress Cily - Slate/Zip Phone <br /> l��rl� C� W�� 2 <br /> Eleclrical Conlrador Mail Address City Slale2ip Phone <br /> Slato License Number Contract Price o(Work <br /> Proposed Use o(Buildinc� Conlact Pe:son (Plan Review) <br /> Descriplion o(Wark lo�e Done: ,�I 2�`'�I-' `-'�2� I '�/�C��t \ 1 <br /> —�7—�.. <br /> NOTE: WIRING IN NON•DVVELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX GODE IS 3105 <br /> 1 hcroby cerii(}�Ihat I ha��e read�nd exnmined fhis application and know the same fo be frue and <br /> conect. All prov�sions o/la�rs and ordinances govemmg fhis t}�pe ot wark�vill be completed <br /> �vhefher speci(ied lierein or not. The c�ranfinc�of a pernut does not resume fo givo aufhonty to <br /> viula(c or cancel tho I�rovisions o/any ofher stafe orlocal la�v reguPting cons�ruchon or the <br /> performm�ce o(consfiucfi i. That am aufhorized by Ihe o�rner of this properiy fo pedorm the <br /> �vork lor u�hich applicati is mad�nd 1 comply n'ifh fh� State ConUactors La�v 18.27 RCW and „ <br /> 296. WA%y/�` �..a I1 O� ' D �yl <br /> i � l� ! �// <br /> Sic�nature Uale <br />