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� ' <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br /> ��l� f�G� C IG�"•�i <br /> PROJECT ADDRESS <br /> Owner Mall Address Clry State2ip Phone <br /> Tenant Mall Address Cily SUIe/Zip Phone <br /> �j`�,/ ,^,-�-'� <br /> Eledfical Coniractor Mail Address Clty State2lp Phone <br /> ` �G' v <br /> Slate Llconse Number Contracl Price of W ork <br /> Proposed Use of Buiiding Conlact Person (Plan Review) <br /> / � <br /> Description of Work to Bo Done: G /K e- / <br /> NOTE: WIRING IN NON-DWELLINGS IS RECUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cenily thaf 1 have read and examined ihis application end know the seme to be frue and <br /> correct. All pro�!slons ollaws and ord7nances goveming this type olworl;will ba complefed <br /> whether speafso herein or noL The granting ol a pertrdt does nof presume to give authonty to <br /> violate or cancPl the provisions of any other sfete or locel law regulating construdion or fha <br /> perfortnance o(constrvction. That 1 am euthorized by fhe owner o/fhls property to peAorm the <br /> work/or which appllcafion is mede and 1 comply with fhe Sfafe Confracfors Law 1B.27 RCW and <br /> 296.200 WAC. <br /> U rit� w-� 6 - �� • v 9 ����,'� (� <br /> ��ature / Date <br /> i <br />