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, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 7-IS--b� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��506��06 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ,J 7 // 1�4K�,E A�i' �VE��7r 9 g�01 <br /> PROJECTADDRESS <br /> � PvJ v vPNf��SA �u�l're 1711 I�J'�E�cflut �VGlLctr %�pl �y,75)3� 6/L <br /> Ownor Mall Addr ss Clty Slale2lp Phone <br /> Nq� <br /> Tenant Mail Address City Slate2lp Phonu <br /> � ( '� <br /> Electdcal Contractor Mail Address Ciry State/Zip Phone <br /> State License Number Contract Price of Work <br /> ,\�SI�EnLo — <br /> Proposed Us�ot Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: O� ��EC ����r`� �4���'�Pr'� ��— <br /> �' //� �l �!l'1 / - <br /> i� <br /> !' <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 /> I heroby certi/y Ihaf I have read and examined lhls appliceflon end know th9 semo lo be true and <br /> correct. All provislons o/laws end ordinances govemin�fhis type o/work w711 be complef�d <br /> whelher sprc�fied herein or nof. The granting ol e pennd does not presume fo give aufhority to <br /> vfolofe or car,cel fhe provisions oI any other state or/ocal lew regulaling construcfion or fhe <br /> performance o/construcfion. Thef I am authorized by fhe ownei o/fhls property to peAorm fhe <br /> work(or whlch applicalion Is made and 1 comply wifh fhe Sfafe Confrecfors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> latj�� 1. �j / �_� <br /> ignature � / Dale <br /> � �l"/o <br />