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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE .TT PERMIT SERVICES <br /> 32J0 CEDAR STRcET, EVEREi"T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROPA 8 AM TO 4 PM <br /> y��s ��h �s�,���T ��r� <br /> PROJECT A�DRESS <br /> c:;�=���=k s�`�N C d T.l.�i <br /> Otvner h1ai1 Address Cih� Slale/Zip Phone <br /> Tenant t�tail Address City Slate2ip Phone <br /> �� � , N�,y �-�z �,�� c <br /> EleClrical Contraclor Mail Address City Stale/Zip Phone <br /> /�lC�il� �'�G� � N T <br /> Slate License Number Conlract Price of Work <br /> sr-� <br /> Proposed Use of Build�np Contact Person (Plan Review) <br /> Description of Work l0 6c Done: J�'�l:, -S�r� 20� � J.l� p <br /> NOTC: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �'S,� 0 0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhal I have read and examined this applicafion and kno�r fhe ssme to be tn�e and <br /> conacL All provisions o!Imrs and ordinances gavemm,q fhis fype o!work will be completed <br /> �rhether specilied herein or noL The granfing o/a perrnd does nof presurne to c�ive authonty fc <br /> viol�fe or cancel(lie provisicns ol airy ofhar slafe or locel law reyulnfing construction or the <br /> perfomiance oI consfrucfion. Tha(I am authonzed by fhe o�vner ol Ihis pwperty to perfom�the <br /> work for which applicafion is made and!comply�vith fhe Sfate Confrac(ors Latv 18.27 RCW and <br /> 296.200 WAC. <br /> n <br /> �' � �� " ��-0�+ � <br /> igna�ure l Dale ^� <br /> �� � - � I <br />