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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES / <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /-/'S i3 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I l (i'1 �.t� Jtit �vc JAI) <br /> PROJECT ADDRESS <br /> wner // Mall Address , City State/Zip Phone <br /> O <br /> ir O� -1 r^ t 1 - <br /> Tenant <br /> Mail Address City State/Zip <br /> Phoria <br /> _. W/;- *7 P_O3 j <br /> x I' S Pn t c r� lo Z"'�L r 2Q/'t Q✓G f< <br /> � t'r� L. State/Zip Phone <br /> Electrical Contractor Mail Address City <br /> i .—. <br /> r Contract Price of Work <br /> Stateiicen <br /> Lise Numbei <br /> Proposed Use o1 Build 9--= Contact Person (Plan Review) <br /> S (II residential new construction, remodel or addition) <br /> quare Footage <br /> Description o1 Work to Be Done: 1�ed&C 4.?- Gn'lefer P_4N <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 herby codify that I have read and examined this application and know the settle d �e to be true anr 3 O 1 - 093 <br /> correct All provisions of laws and ordinances governing this typo of work will becompleted <br /> whether specified herin or riot. The granting of a permit does notp rsume to give authority to <br /> violate or cancel file provisions of any other state or local law regtrlafing conshucfion or file <br /> pertomrance of construction. That I am authorized by the owner of fhisigropedy to perform the <br /> work for which application is rnado and 1 comply with 1110 State Confrac ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �- Signature a e <br />