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� <br />� <br />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 <br />a 10 ��� c,k�e-r-� A-ve�z �.c � <br />PROJECT ADDRESS <br />���- l c�-n �m � <br />Own <br />Tenant <br />� h n h a� v� �2u.�lc.�'�� �"1/�r�� w�4, Rg�o � <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�coo—S�a—NSc�g <br />P���rmance Ele�-�-ri c� �3 o-t agand ►�1 N�,J ��anwood Wr� gga�a <br />Electrical Contractor Mail Address City State/Zip Phone <br />PEl2_ I�DG( �t 1� 08� <br />State License Number <br />/ie� id�n�� <br />Proposed Use of Building <br />���� <br />�' .: <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �: ���( � v� �'�/1'1-O U e- I r f�: f� L L� 2�.- �_ �,�1� �`� E-�.�l�J � P. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />� �� <br />� <br />I hereby certify that 1 have read and examined this application and know the same to be true and �� � � s�� � <br />correct. All provisions oflaws and ordinances governm� this type of work wil/ be completed � <br />whether speafied l�erein or not. The granting of a perm�t does nof presume to give authority to <br />violate or cancel the provisions of any other stafe or local law regulating construction or fhe <br />performance of consfruction. That I am auihorized by the owner of this properfy 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 />���.t�c_�r� �- s - I <br />ignature <br />