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ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SEr�VICES I <br /> 3200 CEDAR STP.EET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wv✓w.everethva.org <br /> APPLICATIONS ARE ACCEPTED F120M 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> 27q� Cct,d y �✓l� <br /> PROJECT ADDRESS � <br /> f,1�o��,K M�{7��L. ��c p.e. gox f26� �vr�af�T <br /> Owner Mail Address City StatelZip Phoce <br /> K�Y 6irn'k 2�a> ro�dvT E <br /> Tenant Mail Atld2ss City State2ip Phone <br /> Nq>,��� sl6i✓ COIY�• lZSS G✓83fG/YkF M'Gf.�1. S��sr�' 98io9 �v�z�2 c�a0 <br /> Electnr.al Contractor A1ail Address Ciry StatelZip �e <br /> �✓��ivs c e?�nz3 �S'oo� <br /> State License Number Contract Price of Work <br /> �.r�k S>�� z�d����,✓ <br /> Froposed Use of Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: l^�fr��� ��� f�^�«� �A�� rLINN(N��p �,✓� fl�^rf , <br /> H�c un ro Fx�f>„�� s�6�✓ ���N��rr� <br /> � <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 /> 1 hereby ceRily that 1 have read and examined this application and know the same to be true and <br /> carect. A!I provis�cns of laws and ordinances governing this rype of work will be completed <br /> whether specr�ed her n or nol. The granting o/a permrt dces nof presume to give authonry to <br /> violate or ca el fhe ovisions of any ofher state or local law regu/ating constr�efion or the <br /> pedermanc /con uction. That I am authonzed by the owner o/this property to peAorm the <br /> work tcr wh appl' fion is made and I ccmp/y�vith the Sfate Contractors Law 18.27 RCW and <br /> 296.200 W . <br /> ��,��y. <br /> �g ature Oate <br /> �� /lo- � <br />