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ELECTRICAL PERMIT APPLICATIOh <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& CREDIT CARDS ARE NOT ACCEPTFD <br /> /DS/� CII��°5�-e,>l Zvt��— <br /> PROJECT ADDRESS � <br /> j��t wwvte. I%i�i?� <br /> � � ., �.A /b S/5 �'U��''S''�.�,'� 2� <br /> 1� <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant Mail Address City State�ip Phone <br /> �t���� � �y�z, ,�<<����- �aue�� 51 .l�e,��,�1�- T�.,/�5�3rec <br /> Elec 'ca�Contractor Mail Address City Slate2ip Phone <br /> �6�t ;%��� D� �� ��v <br /> State icense Number Contract 'ce of Work <br /> �� K. (�`�S�e(;�5 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> - � � � � " <br /> Description of Work to Be Done: �,�.(�`� �(�/�(� �,G/� Q��it�--� <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 ceRify that 1 have read and exam' d this application and know the same to be true and <br /> correct. All provisior.s nflaws and ordi nces govemmg this type of work will be completed <br /> whether specified hereut or not. rhe anting of a permit does nof presume to give authority to <br /> vio/ate or cancel the provisions of other state or/ocal law regu/ating construction or the <br /> performance of construction. Th I am a thorized by the owner of this property to peAorm the <br /> work(or which applieattrnrys e an -comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC / <br /> ; <br /> J 3- T- vs <br /> Signat Oate <br /> Eo5n3-d49 <br />