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( i <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 —wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> y���� �1��✓r,��oD /�v�' �1��i2e � lJ� ��Z� 3 <br /> PROJECT ADDRESS <br /> %�CN,��L �/1CN/�i�LJ� �D�JGZ� ��s � ,U2 S� /yJLL C/l�'CK �J�Q �Q 3� <br /> Owner Mail Address City SWte2ip Phone <br /> /V� <br /> Tenant Mail Address Clty State/Zip Phone <br /> EleclriCal Contraclor Mail Address City Stale2lp Phone <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be D�ne: GfIECK �X/� //��J�° ���'�� _ <br /> /�0�✓�/' i s rv/'N�/� 6nwc oN <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 certi/y fhaf 1 have read and examined this application and know the same fo be true and <br /> correct. All pro ions ollaws and ordinances goveming this fype o/work will be completed <br /> whelher s ied herein r nof. The granfing o/a permit does not presume to give authority to <br /> violate or�ncel th�pro �sions oI any other slate or local law regulating construction or the <br /> peA�r/Qe o/con tru on. That 1 am authorized 6y the owner o!this propeRy to per/orm the <br /> wor /or i4 ich appl caf n is made and 1 comply with the State Confrac(ors Law 18.27 RCW and <br /> 2y6.20� 4�. � a � � ��3--�/ V <br /> r � J <br /> . <br /> Signaw ate <br />