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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3100 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 <br /> •-'t r50� Gam/ "'� <br /> PROJECT ADDRESS / <br /> Own Mall Address Gty State/ZIP Phone <br /> Tenant T Mall Address City State/Zip Phone <br /> /.3 r4 lar''Jc9y-ap <br /> Electrical Contractor Mall Address City Stale2ip Phone <br /> Stale License Number Contract Pric f Work <br /> �� ✓ zo6 43r-LbSI <br /> C <br /> ProposodIftil'of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> 4�iy�fP <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 9105 r� <br /> I hereby fit) that 1 have road and examined this application and know the some to be true and L=l Ol)I - L'� <br /> correct. All provisions of laws and ordinances govemingp this type of work will be completed <br /> whether specified herein or not. The granting of a perm I does not resume to give authority to <br /> violate or cancel file previsions of any other state or local low regulating construction or the <br /> parforrl�r I consfrucbon. Tiret 1 authorized by the owner of this property to perform(lie <br /> wgrk for which ppllceflon Is made I comply with the State Confrec ors Lew 18.27 RCW and <br /> 286.200 C. <br /> Signature/ le <br />