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— - — � <br /> ELECTRICAL PERMIT APPLICATIUN � <br /> CITY OF EVERETT PERMIT SERVICES Q��`d`� <br /> 320C CEDAR STREET, EVERETT, WA 98201 L.�p(��� „��� <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 /> I <br /> � � � �s����� <br /> PROJECT ADDRESS <br /> G � _S �2� ��(o �-c��l �`�� �'yl a/ <br /> Cwner Mail AdOress City State ip Phone <br /> yzr 3j5�:�r�1 <br /> Tenant Maii Address City State/Zip Phone <br /> ��ti' '_ 5 4�-� <br /> ElectriCalConVattOr MailAddress Ciry State.2ip Phone <br /> � <br /> 2 C1L3� . <br />' State License Number Contract Pnce of Work <br /> s � 2 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /n' �1 e <br /> Description of Work to Be Done: Q�` `-1 /�(/ � �j � QQ�[ $��i 5'al✓�Y�.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y fhat/have read and examined fhis application and know the same to 5e true and <br /> correct. All provisions ollaws and ordinances govemmg fhis type ol work will be comp/eted <br /> whefher speci6ed herein or not rhe granting ol a permd does not presume to give authonty to <br /> violate or cancel the provisions of any other state or/ocal law regulating construc;ion or the <br /> pe�ornance of construct�on. That/am authonzed by the owner o(fhis property to per/orm the <br /> work for which application is made and I campty wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �r� � 2 3 � <br /> Signamr te <br /> r_ <br /> GZ ��a % ' ! �' �, <br />