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� ! <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> %Z Z 7 �aSCo�/G !//� <br /> PROJECT ADDRESS <br /> /" '/�� �(/1 J /Z Z � �lYiYYC-� VI l'.✓C�.� l.��I <br /> Ownef Mail Addresn City SWte/ZJp Phone <br /> Tenant Mali Address C'ty SWtaZp Phone <br /> .)c� G�i E ��fr,'c�, l <br /> ElecMc�tor MallAddress Ciry SWte/7Jp Phane <br /> Stale License Number Contract Price ol Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriptlon of Work to Be Done: /i� .J %i�-/vA�. fo /�C'�cr �arn f u/. ;✓,�il!-i . <br /> i�T <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 /> l hereby certily that I have read and examined this appllcaffon and know fhe seme fo ba true and <br /> conect. All provisions ellaws end ordinences goveming this type o!work will be completed <br /> whefher specifietl herem or not 7he granfing o/e permd daes nof presume fo give euthonty to <br /> violate or cancel fhe provisions o/any ofher stafe or local law rep�letlnp constructlon or fhe <br /> peAormance o/construchon. Thet I em euthonzed by the owner ol fhis property to peAorm the <br /> work lor which application is made�and I comply wifh the Sfate:'ontrectors Law iB.27 RCW end <br /> 296.200 WAC. / /' � � <br /> � -% <br /> �� �, /�`�� /�G,S �.� <br /> Sipnature � � Date <br /> � 05�/- I�z <br />