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( i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 96201 <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /20 2 l.uC-T�erZE RvC- <br /> PROJECT ADDRESS <br /> G.�-a �rs�.v�2 �zoZ rr�r.�o� .�,,�- C-✓r�,�rr' c�/N-/�, 4cse�9-9esp <br /> Owner Mail Address City Slate2lp Phone <br /> Tenant Mail Address City StatelLp Phone <br /> �(�-�LB� <br /> Electrical ConVactor Mail Address Clty State2lp Phona <br /> Slate License Number Contract Price ot Work <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descriptionaf Worklo Be Done: /NO✓E �x�UfLE Tw,vi� , ��✓S7'*C L rt/�/ 7.� /►.�� <br /> �A�t/t L- <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 �f l� <br /> 1 hereby ertily thaf 1 have read and exemined th(s epplicetion end know the sarne fo 6e hue end �I I � � ~I l I <br /> correcf. 11 provklons ollaws and orrl7nances govem(ng thls rype ol work wlll be com�leted <br /> whethe peclfled herein or no(. The grenting oI a permit does not pres�me fo glve euthority to <br /> violato rcencelthe provisionsolanyotherstateorlocallawreguletingconstructlonorfhe <br /> peAo n e of construction. That 1 am euthorized 6y the owner o/fhlsp roperfy fo peAomt fhe <br /> work !ch application is made and 1 comply with fhe Sfate Confractors Law 18.27 RCW and <br /> 296. AC. <br /> � �D'L'l-/� <br /> ature oate <br />