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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 /> / &? �IvC �y 17 'x . F ��� i7 4.✓� q 2ny <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip LPone <br /> "xiLC. S <br /> ,0 J_ k r LF_aAZC_ %? .C �.i, ,Z 11 7 LA.,,q ?S:e?c 7'W-7c,�-y <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 0 l-, rz.L /_ k,& 9 �0)`T_ _�S 50. 06 <br /> t r <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �' >�� T)E-h-i,P, S'C-'n l,, C..- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> l�C, ) <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby certify that I have read and examined this application and know the same to be true and ( � <br /> correct. All provisions of laws and ordinances governing this type of work will be completed -' V(} <br /> 9 - 06 <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. That/am authorized by the owner of thisroperty to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> R, Signature Date <br />