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r � <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—ww�n�.evereriwa.org <br /> APPI.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � � `� ln1 e,�"1�1 a��� �l�C <br /> PROJECT ADDRESS <br /> ��G.ker,� �' I�eS - <^��me � c;.,��v�c <br /> Owner Mail Address City SWtelLip Phone <br /> Tenant Mail Address City Statel7Jp Phone <br /> 1 �� �� y <br /> (��,.,,� s �le�fr�G >3/ ZSo� Sf�rrti� sf•.��.�/ wA �ss�iy � �� <br /> Electrical ConUaCtor Mall Address Clry SWle2tp Phone <br /> CI�4�r��=To 3 �k�r ��� � <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> I /� . �/L �/ <br /> Descriplion oi Work to Bo Done: I �I 1L L ��V� �[/�y p � �7�2 fa( �✓1 ��P <br /> S �tG�N .I��t. - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED T(1 FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that f have read end axemined fhis application and know fhe same fo be true end �I� )� '� y 3 <br /> correcf. All provlslons ollaws and ordinances goveming this type o/work wlll 6e complated <br /> whefher specified herain or not. The granting ol a permR does nofp iesume fo g7ve authority to <br /> viola!e or cancel the provisions ol any other state or loce/law regule0ng conshuctlon or fhe <br /> performance o/construcflon. That 1 am authorized by fhe owner o/fhis property to perfortn the <br /> work/or which epplkafion!s made and 1 comply w7th the Sfate Confrac(ors Law 18.27 RCW end <br /> 296.200 WAC. <br /> ,� .% G�- l�-�Z l" ?�l/ <br /> SI nature Date <br />