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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> OTLI s7 S Z o3 <br /> PROJECT ADDRESS <br /> Owner Mall Address City Statemp Phone <br /> Tenant Mail Address City State0p Phone <br /> o/t7--T</�z 11-12 W,4 <br /> Electrical Contractor Mall Address City Statemp / Phone <br /> ll��G )65 1-Z 19L <br /> 19p W e/e <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person//(Plan Review) <br /> Description of Work to Be Done: / 1��(l� — �.w /,i) JA -1 e? 6z" <br /> Syj-s 39 3� <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 /> I hereby certify that I have read and examined this application and know the same to be tme and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction, at I am authorized by the owner of this roperty to perform the <br /> work for which a Ilcatlon Ism de end 1 comply with the State Comracfors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> Signalu ; Date <br /> �j ley <br />