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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org �� _ �2--BC-{ <br /> I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> j��2(� � �- I ��y'1`�i �'�[ <br /> PROJECT ADDRESS <br /> /� c <br /> � I'1�� � �� f'��) ;> > �)r� �_�— <br /> Ownef t,tail Address Gry State,'Zip Phone <br /> Tenant b1a�l AdCress City State�Zip Phone <br /> 5�,�,�nlT E�C�-�121c �N�- G���3 i'hl�.r57- /���J STFlNwa��p C�A �`b �;� Z <br /> Electrical Cont2ctor Mail Aadress City State2ip Phone <br /> � �25 �� 575� <br /> i��rr!�n !C 1 ra�_� ;< '2, yC�`� <br /> State License Number Contract Price of Work <br /> J `� � <br /> Proposed Use of�uilding Contact Person (Plan Review) <br /> �� <br /> Description of Work ta Ee Done: i�i "-L NCI� ! 5 � !- <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLc. <br /> CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat I have read and examined this application and know the same to be frue and <br /> correct. Al!provisions of/aws and ordinances 9ovemin�tbis type o/wak�vill be completed <br /> :vhether spea(ed he�ein or noL The granfing ol a permrt does not presume to give authonty to <br /> violate or cancel the provisions ol any other state cr/ocal law regulating consrroction or the <br /> performance o/construct�on. That I am authoriz=d by the owner of this property to pedorm the <br /> �vork for which applicafion is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � --- N�V � � ^u���i <br /> Sigraure �ate <br /> �� � � - �- ;�- <br />