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f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF E\/ =RETT PERMIT SERVICES � �`u <br /> 3200 CEDHR STREET, EVERETI', WA 98201 �" <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org E��Og_('-�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /i l� �Sr`` S trc� — �✓�a�1, u��A . Q�y o � <br /> PROJECT ADDRESS <br /> ,���� C�,���..�� ��x s�s �o��o,�vs ��. 9�zo 9�s�>7� <br /> Owner Mail Address City Slate2ip Phone <br /> ���� <br /> Tenanl Mail Address Cily Slate/Zip Phone <br /> p;�'r�F'L <br /> Electrical Contraclor tdail Address Cify Stale/Zip Phone <br /> Stale License Number Contracl Price of Work <br /> ���A � <br /> Proposed Use oi Building Contact Person (Plan Review) <br /> �E!'I�CE p�P_��� � fJ,S /'EIL /.l,Y• <br /> Description of Work to Be Done� f- f_ <br /> NOTE: WIRING IN NON-CWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby�ceRify that I have read and exarnined this application and know the same to be Irue and <br /> correct. All provisions o(laws and ordinances goveming fhis type of work will be complefed <br /> �+�hefher specdied herein or noL The granting o(a pernut does not resume to give authonry tu <br /> violafe or cancel the provisions of any ofher state or local law reguPting construction or the <br /> pedonnance of construclion. That 1 am authonzed by Ihe owner o((his property to perfo�m the <br /> �vork lor which applicafion is made and 1 comply�vith fhe State Confraclors Law 18.27 RCW and <br /> z96.2oow�,- , � �y <br /> � � c,,a,�- <br /> (;�G " !���� �!— i/ <br /> Signalure � Date <br />