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• <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � --�-oY <br /> 3200 CEDAR STREET, EVERETT, WA 98201 L OCJ 07-D� <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 ACCEPTED <br /> E7 !< Jr �..0 /7it /�.Q.G.c r c (. <br /> PROJECT ADDRESS <br /> —� �H � - t� _ � ve .�.t% <br /> owr�er • � tdail Address yCiry Slale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �7S'd' �����- .2�i� 7�s'�-s�. ���,t ti �.�-� �s�� .�s.s s.�y� <br /> ElecUical Contractor Mail Address City Slate/2ip Phone <br /> i7 S „/ �L n•� cJ.Z.Z��Z _ <br /> Slale License Number Contracl Price of Work <br /> C.,—.- lx-:c<'ti fJ:� <br /> �r_ <br /> Proposed se of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: ��1 7Ly ��lx a <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 /> I hereby certify tnat I have read and examined this application and kno�v the.�ame to be true and <br /> correcL All provisions o//aws and ordinances govemmg this type eI�voik�vill be comp/eted <br /> whether specified herein or not. The granting o/a pernut does not resurne to give authority fo <br /> violate or cancel the provisions of any ofher state or local law reguPting construc6on or 1te <br /> per/ormance o/construchon. That I am authorized by ihe owner o/this property to perform ihe <br /> work(or which applica6on is made and I compty wifh the State Contracters Law 1827 RCW and <br /> 296.200 WAC. <br /> . , <br /> ��c' � ` 'G�c,��� � <br /> ��. t�.y. . <br /> ISir,nature Date <br /> E� "��i�'CZ I <br />