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1 <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � 33 i c� cSrn�T sT <br /> PROJECT ADDRESS <br /> NAA��- r��`� <br /> Owner Mail Address Ciry Slale2ip Phone <br /> Tenant Mall Address City Stale2lp Phone �I <br /> �rnm�T ECL�Tf� c. <br /> ��-I�- 6 21�3 26 Isr 51- N W 5TA ni wa�D l,�A �i� 2�2 <br /> EIeCMcal Contractor Mail Address Ciry SWIe21p Phone <br /> s� ,rhm 1E i nx KZ r��, y1.5 30� 5�59 <br /> State License Number Conlract Price of Work <br /> SFz <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptian of Work to Be Done: �.J� I"� ��� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIP.ED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> C�TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heieby certily fhat 1 have reed and examined this applicaflon and know the same to be true and <br /> correct. All provisions ollaws and ordinances goveming th�s type ol work will be complefed <br /> whether spec�(ed herein or not rhe granfing ol a permd does not presume to give aufhonty fo <br /> v�o/ate or cancel fhe provlsions o/any other sfafe or local!aw regulefing construcbon or fhe <br /> peAormance o/construction. Thet I em authonzed by the owner ol this property ro peAorm the <br /> work lor which app/ication is made and I comply wlth the Sfate Confracrors Law 18.27 RCW end <br /> 296.200 WAC <br /> - �--- Iz 'IU• O`1 <br /> S�enawre Daie <br /> Ed�t� a-�sci <br />