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� , <br /> ,, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER�'ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM R AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �OS� C/low� �2(ve <br /> PRQJECT ADDRESS <br /> M1L d- Mns SfIP� /o�° ��ow^� L{Z G` V�n -� <br /> Owne� Mail Address City Sate2ip Phone <br /> Tenant Mail Address City State/7Jp phone <br /> N�9�.str E�E�r�,� �-r � ��►lo zzNa srsE �V�2�� w�, 9�z�S yzs-33X9S►�z <br /> Electrical Conttactor Mail Address City � Slate2ip Phone <br /> � u —� – 5 <br /> -N�t,�s c t-_r o r z nA S, o.��. �� <br /> State License Number Contract Price of Work <br /> RES�ptr�cc /)aqvE l-l�Nlt^' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work ta Be Dona: TN,ST•;LL SU��q��� �NQ �E I.�/n E / �9nT� F T�� <br /> �(-1_SE/��N-� <br /> NOTE: WIRING IN NO�-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> t <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y that I have read and examined this application and know the same to be true and <br /> conect. All provisions ol laws and ordinances governmq this type ol work will be completed <br /> whether specified herein or not. The granting o(a permrt does not presume to qive authority to <br /> violate or cancel the provisrons ol any other state or local/aw regulating consh�cfion or the <br /> peAormance o/construchon. That I am authorized by the owner of this property to peAorm the <br /> work lor which application is made and I comply with the Sfate Contractors Law 18.27 RCW and <br /> 296.200 W(1C. <br /> ��L2�� ��-- 1�1��"�° I <br /> Signawre ' Date <br /> �����c --(>�� <br />