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� <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 FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ApE NOT ACCEPTED <br /> .,:`r0 S Fu[T�Nt E uER 6TT , r,vA: <br /> PROJECT ADDRESS <br /> �zs�33�-�y�I� <br /> �7 irU Roc.q Nn �. a 13ch 87s (�KE srEuE,vr krq � <br /> Owne� Mail Address City StatelZip Phone <br /> Tenant Mail Address Ciry SWte21p Phone <br /> Electrical Cortracla� Mail Address City State2ip Phone <br /> Stale Lirense Number Contract Price of Work <br /> Proposed Use of Builcing Contact Person (Plan Review) <br /> Descriplion of Work to 6e Done: U �(Slef��� Z �XJ �n'1� S�1/I�E <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 3705 <br /> I hereby certily that I have read and examined this application and know the same to be frue and <br /> correct. All provisions ollaws and ordinances goveming this rype o/work will be completed <br /> whefher speci�ed herein or noL The�ranting o/a permd does not presume fo give authonty fo <br /> vio/ate or cancel the Provisions o(any oth�^state or local law regulating construction or the <br /> peAormance ol construction. That 1 am aui�,,nred 6y the owner ol this property to pedorm fhe <br /> work lor which application is made and 1 comply wifh fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. 1 <br /> �� y-� <br /> .�,-t, ' %�f S/3/�s <br /> SigtlaWre Dale �� <br /> �� � <br />