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--�_ - <br /> ELECTRICAL PERMIT APPLICATIC�N <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 /> 3 b �I 6 �`a a�l w av <br /> PROJECT ADDRESS <br /> Owner Mail Address City Slate2ip Phone <br /> S��` b u<ks Z�oo �s�,�u� s .seq`(�1� w�4 `� �13 '� <br /> Tenant Mall Address Clty Stale/Zip Phone <br /> /t'� N�a Zon S� O rcvs S� S�4� I� W� � � �Z� � <br /> Electrical Contraclor Mail Address City SlateRip Phone <br /> /�'1N�a�f L� 01 .6L1' �50D, b0 <br /> State License umber Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Wark to Be Done: � N ��QII����` O� I�Q W VO���_� l'" <br /> �C1u� ��v' U S\�S�P u�l <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 /> 1 here6y ceRi/y fhat 1 have read and examined this application and know t'�e sams to be true and <br /> correct. All provisions ol/aws and ordinances governing th�s type o(work will be completed <br /> whether specified herein or not. The granting ol a permit does not presume to give authonty to <br /> violafe or cancel the provisions o/any otherstate orlocallaw regu/ating construchon or the <br /> peAormance ol consfruchon. That 1 am authonzed by the owner of th�s property to peAorm the <br /> work for wltich application is made and I comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �" l �%� � b <br />� " .Si ature Date <br /> � <br /> ;' E(7N [ Z-O?� I <br />