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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 14�� c�e�Tn� T <br /> PROJECT ADDRESS <br /> f-1�A�K i��� <br /> Owner Mail Address City State/7Jp Phone <br /> Tenant Mall Address City Stele/Zlp Phone <br /> yJMrrllr C�I=�IF1�. GZo3 ZGlsr S� N�,�J ��77,�►t�x�D wA 9�2q2 y2� 3a8 5) <br /> EleCtdcal Contractor Mall Addmes Clry Stale/7Jp Phona <br /> S�,rn�� 1C, Oc�c� K"L �l Sau <br /> State License Number Cantract Prlce of Work <br /> Sr= (� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescripUon af Work to Be Done: �:JO /'�M� jE��1�E w� (�E N�Ii,J S�'� <br /> NOTE: WIRING IN NON•DWELLINGS IS REGUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIF. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 7105 <br /> 1 hereby certily that I heve read and examined fhis applicotion and know the same to be frue enc <br /> correct. All provisions o!laws and ordinences goveming fhis type ol work will be complefo0 <br /> whefher spocdied hereln or not. 7he granting ol a permit does notp resuma fo give eufhority to <br /> vlolete or cancel the provisions ol eny other state or local lew regu/eting consfructlon or the <br /> peAormance o/construcfion. That I am authonzed by the owner ol th�s property to perform the <br /> work lor which application is made and 1;omply with fhe State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �`-- �-- �—' 2'�p ' �S <br /> Signature �ata <br /> �v��� / 3 `� <br />