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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-25?-8857 —www.everettwa.nrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> !1 <br /> '%-�� ,,.��.� 1 <br /> PROJECT ADDRESS / <br /> I <br /> Owner I.qail AaCress Gry State.2ip Phone <br /> �"��1 � /G'lJG'K_/ <br /> Tenanl fdail Address City State/Zip Phone <br /> � ��C ) <br /> (� _ <br /> Electrical Contractor fdail Address City StatelZip Phone <br /> �'���r-��l yG � ,� � <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Oe Done: ` � �L�JP_� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily that 1 have read and examined this applica(ion and knr,w th�same to 6e true and <br /> correct. All provisions ol/aws and ordinances goveming this type olwork wdl be completed <br /> whefher specdied herein or ncL ihe granting ol a pemat does not presume to give authonty to <br /> v�ola(e or cancel the provisicns o1 any other state or local law regulafing construction or the <br /> performance o/construc6on. That/am authonzed by the owner ol this property to perform the <br /> work lor which applicatipn is made and I comply with the State Contrectors Law 18.27 RCW and <br /> 296.200 WAC. i <br /> V���z ��'a�--- / z � Zj - � 4 <br /> �� o�.^,n;wrc- �- Dare <br /> i � <br /> ��j�. - j�_�f <br />