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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �12���" <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TC'4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> PROJECT ADDRESS <br /> n,��_ P� ;for �, <br /> (hvner Mail Address Ciry StatelZip Phone <br /> ta�tp-�P•. IS< 2C..,T � �,c� /Z rc� n,o.,.� Wn `/t�-)d �-4475 <br /> Tenant Mail Address Ciry State/Zip Phone <br /> Bi.S�e. /�`j�io.,.G �c2UlC�... toCLS rY7�A�K. S�. l/V�u�(I�+ V�IIt ��lJ(n . i'„fr0�2 1�(,-�YI�S7f�� <br /> Electrical Contractor Mail Address City State2ip Phone <br /> t4�, s1�� s 9ioBk �������� <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: ' �I C� �w ti� c 1 �,.;t,� <br /> NO'fE: 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 cediry fhat 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type ol work will be completed <br /> wltefher speci�ed herein or not. The�ranting o/a perm�t does notp resume to give authonty lo <br /> violate or cancel fhe provisions ol any other sfate or local law regu/afing construcfion or lhe <br /> peAormance ol construction. That I am authorized by the owner o/fhis propeRy to perform th�i <br /> work for which application is made and I comply with the Sfate Confractors Law 1R.27 RCW and <br /> 296.200 WAC. <br /> — 9 � <br /> ��� r�"� �.�.�,-.. �l �i � �° �� / <br /> SignaWre (-� ' Date �� <br /> ! ,� i <br /> �V <br />