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ELEC�'QICAL PERMIT AP^LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIC NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS ^' / 1 <br /> / l' I V <br /> /V <br /> Gwner Atail Address ,^, Ciry State/Zip Phone <br /> U <br /> Tenanl Mail Address Ci1y r State/Zip Phone <br /> C " <br /> , <br /> , <br /> Electrical CoNraclor tdail Address /. C'ity State2ip Phone <br /> V <br /> ^ �n� <br /> Sla�e License Number ,� 1 Y 1 Conlract Price of Work <br /> _�a�� � � <br /> , <br /> , <br /> Proposed Use o(Building ��� ' � Conlact Person (Plan Review) <br /> Description o(Work lo 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 /> 1 hereby cerfily Ihaf I have reaA and examined fhis appliwfion and knou�fhe same to 6e tn�e and <br /> conecL All provisions o(laws and ordinances goveming fhrs fype ol work will be wmplefed <br /> whefher specilied herein or noL The granting o/o pernut does nof resume to gire aufhonty fo <br /> violafe or cancel fhe pro��isions o!any other sfate or local law reguPfing consfructwn or fho <br /> pedormance o!construction. Thaf 1 am aufhnrized b}�the owner o/this property to pedorm the <br /> �vork Ior�vhich application is made and 1 compty with the Stafe Conlracfors Law 18.27 RCW and <br /> 296.200 41�AC. <br /> ��/,G�C%��/ <br /> Slgnalure Date <br /> tU&vl � v� a- <br />