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S <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 5 � �� _�Z <br /> 425-257-8810 - FAX 425-257-8857—www.everettws.org C /��`o,�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ia �af �q� k�Ellcl� 5� ��i1 w� �� <br /> PROJECT ADDRESS �- <br /> Owner Mail Address Cily Stale/Zip Phone <br /> �i�t��� �� � �i o t ►q +'^ l�� 4E E�� (�i� fS�zos <br /> Te�anl Mail Address Cily State/Zip Phone <br /> 17V� <br /> Electrical Contractor Mail Address City StatelZip Phone <br /> � �����f�f Da �/ �JfJ . �� <br /> ate License Number Contract rice of Work <br /> Proposed Use o`8uildinc� Contact Person (Plan Review) <br /> Descriplion of Work to 13e Done: /�l S��L l �!�� �r^�-^��!'GS <br />� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAf3LE. �—�-�� <br /> � <br /> CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and exornined this applicafion and kno�v the same fo be true and C I � U� ' �� � ( <br /> correcl. All provis�ons o(la�vs and ordinances goveming this type of mork will be cornplefed <br /> �vhether specified herein ornoL The grantin�o(a permd does not �resume to give authority to <br /> viola(e or cancel the provisions o(any other state or locallaw regulating construdion or the <br /> perlor.viance of cons(rucfion. That I am aidho�ized 6y fhe o�vner o(fhis property to perlorm the <br /> work for which applicafion is madc and 1 comply n�ith the Sfafe Con6actors Law 18.27 RC W and <br /> 296.200 WAC. � � <br /> ��` �� � �` 5 /�/� - <br /> �. Signalure Da <br /> I <br />