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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everzttwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i� <br /> � v <br /> `�g 2`l F���U�ee•� l,Ju� �,� <br /> PROJECTADDRESS �)� � <br /> /i'� " <br /> Q v� <br /> Owne� Mail Address City State2ip Phone <br /> S�n C���ES�-`T,,���� ��Zy �����.�-� w�, ���� 1�/� . �g�w3 <br /> Tenant ail Address City Slale/Zip Phone <br /> UC�'ll-Cc� ���2�f �C � f/00 {'IJ,er/'i�I C�/'ee<< /f �i ��c�� WA , ��ZD3 <br /> Eleclrical C ntraclor Mail Address City Stale2ip Phone <br /> ��l� �� Ec=C�� 1�1�4 , � I�`� `� /3 7so �� <br /> Slate License Number �l Contract Price of Work <br /> %�i��lr;�lG �t4�o� �A�,e SNi'Pm�a�l <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: _ t �'J E��S�'J^�, �� C/rlC C(/~�S �iy4 <br /> �/��� T� etJ ��-/�/�%�� �c.L� S, <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 here6y ceAi(y that 1 have�ead and examined this application and know the same to 6e true and <br /> conect. All provisions of laws and ordinances governmg th�s type oI work will 6e completed <br /> whether specilied herein or noL The granfing o(a permd does not presume lo give authority to <br /> violate or cancel the provisions o(any ofher state or local law regulating constructior or the <br /> perlormance of construchon. That I am aufhorized by the owner olth�s property to peAorm the <br /> work Ior which application is made and 1 compty with the State Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> , n � �`� <br /> ' � � r <br /> Si atur Date <br /> � C�{G7-C! (a <br />