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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 Plvt - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �7� D lJP.IGLtJUY�. y�'Ue. <br /> PROJECT ADDRESS <br /> ,�i �c, Wi���S H10 R no 14u/4✓c /'�ve,�,e�� Wv r1f5,?03 C°1�s�dS�`.?2�/y <br /> �Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> , ) <br /> i <br /> L��.-�. �����I� <br /> Eiectrical Contraclor Mail Address City StalelZip Phone <br /> State License Number Contract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Work to Be Done: /t pD(C�L e 1765 � �t� t� tv �� <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 ceRily that/have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming fhis type ol�vork will be completed <br /> whether speci6ed herein or noL The granting of a permrt does not presume to give authority to <br /> violate or cancel the provisions o(any other sta[e or local/aw regulating construction or the <br /> peAormance of construcLon. That I am authonzed by the owner o(this property to pedorm the <br /> �verk(or rohich appli ation is made and I comp/y with the State Contractors Law 18.27 RCW and ,� <br /> 296.200 WAC. <br /> � i a �� qT <br /> I / �� <br /> �gnature .,= ace 1 . <br /> l% <br />