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� � <br /> i'� 'I <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 FROPA 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ���a1_ �' 1�11Q'f�.R., l�f a .�.1� q�01 <br /> PROJECT ADDRESS <br /> �,V�e. �tz4t�en <br /> Ownef Mail Address City Slale/Zip Phone <br /> Tenant Mail Address Cily Slala2ip Phone <br /> blvmp►�Sec�rt�a . PO P�ox 35�i , O.�.Q. _� �J�. G �5aa3 <br /> Elecl al Contraclor ailAddress Ciry State/Zip Phone <br /> 01 m _C?la , P <br /> State License Nu ber Conlracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work lo Be Done: �� ���) �l�1 � ' ` �A�� rn,I r I 1 CA�O, <br /> ����.Q G �1 re. �n1��,J�U <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 /> I hereby certi/y thal I have read and examined this application and know Ihe same fo bo true and <br /> conect. All provisions of laws and ordinances govem�ng th�s type o(work will be comp/efed <br /> whe(her speci�ed herein or not. The granting o(a permil does not prosume lo give aulhonty to <br /> violafe or cancel the prorisions of any ofher stale or local law�Pgulafing construcfion or fhe <br /> peAormance ol onsfruction. Thaf I am authonzed by fhe owner o/fhis property fo peAorm fbe <br /> work for which plicalion is made and I comply wifh fhe Sfste Contractors Law 18.27 RCW and <br /> 296,20 <br /> �I '`i '��� <br /> Sign Wre Dale <br /> `9G��3� <br />