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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 /> APPLIC4TIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i �� C'n5r� r• l�. C��re�-I IJn. 4R�1�3 <br /> PROJECT ADDRESS <br /> , Iri�ilP �irle AuPf.S 1 '� '�l�l LQ5C4C-�(' l�f , �.�iPrPf-1� � .�11, 98 �b � <br /> Owne� Mall Addreas Cly SWte/7Jp Phone <br /> �a� �9� ��o� <br /> Tenant Mall Addroae City Stete/7Jp Phone <br /> ElecMcal COntrectOr Mall AEEress Clry Slale2ip Phone <br /> State License Number Conlrect Prlce of Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> / �/ /� <br /> Description of Work lo Be Done: ��7P�7 ( i C'U/i 5 <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�105 <br /> I hereby certlly that I have read and examined this applicaflon and know the same fo 6a true and <br /> correct. AI!provisions ollaws and ordinences goveming fhis rype ol work will be complefed <br /> whefher speafied herein or noL The granting al a permrt does nof presume to give euthonty to <br /> vlolate or cancel fha provisions o/any other state or local law regu/ating consWctlon or tha <br /> pedormanca ol construcfion. rhat I am authonzed by the owner ol fhis property fo pedorm the <br /> work lor which application is made and I comply wifb fhe Sfate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ���z�`21�4�n n /� n 7 -CL�� <br /> ignalur Data <br /> E � C�/O-c7� � <br />