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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> s�� S TT �,- <br /> PROJECT ADDRESS <br /> Q�lGCIS�d,U/lL.OIJlSYUyvS.SUS �"Wr'.��� L./•�—,_.7 �i�'�� I/UYs— ( <br /> Owner MailAddress Ci� � SW 2ip Phone <br /> ��'V V �-- <br /> Tenant Mail Address City Stale2ip phone <br /> 1�A-Q.Dw�LY F/.�.�,.ic �c. <br /> Electrical ContraCtof Mail Address City Slate2ip Phone <br /> ���OwC� C��.31,L ��}UCl() � `� � <br /> St te License Number Contr,6ct Price of Work <br /> {n, -4-U 1�L� ��I U'WTZ`'' 12 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work(o Be Done: �e� � �'�!u✓C p�v�� / �l�/'� L d v� J � <br /> �.v-� r -�� ��_ f�.�..-�s �d�,�- � - h P�.. <br /> ��}1rJltJi <br /> i✓ 'v1.C/ <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 CQDE IS 3105 <br /> J here6y certi(y that 1 have read ar.d examined lhis application and know the same to be true and <br /> correct. All provisions of laws and o�dinances goveming th�s type ol work wi116e completed <br /> whethei specified herein or not. The grenting of a perm�t does not presume to give�uthority to <br /> vio/ate or cancel the�rovisions of any other state or local law regulatino construction or the <br /> peAormance of construction. That i am authorized 6y the owner o(lhis`property to per/orm the <br /> work for wbich application is made and 1 compty with the Staro Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> Gre Date <br /> E o�(a 8-aoS <br />