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ELECTRICAL PERMIT a►PPLICATION <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 ARE NOT ACCEPTED <br /> ;�LZ � eV�t-%/ �VC/1I�lC <br /> PROJECT ADDRESS <br /> K�,� .�,� <br /> Owner Mail Address City Slate/Zip Phone <br /> ik�; CON� <br /> Tenanl Mail Address City Slate2ip Phone <br /> �'��v /�✓� 9�3Z ,�a�,�v�r�v S�-��� i,v� <br /> Electrical Contractor Mail Address ity SIa�e/Zip Phone <br /> �az�9D/ �y�°`' �� <br /> Slate License Number Contracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work ta Be Done: ,3L� 19�D/7���`1L DU TL��,S <br /> NOTE: WIRING IN NON-D�VELLINGS 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 that I have read and examined this appliration and kno�v the same fo be true and ��}�CU 3 �-� <br /> correct All provisions of laws and ordinances govermng this type o/work�vill be completed <br /> whether specilied herein or not The granting ol a permd does not presume to give authority fo <br /> violafe or cancel the provisions of any other state or local law reg�lating construchon or the <br /> performance o/conshuction. That I am authorized 6y the owner o!fhis property to perform fhe <br /> worV. lor which ap Acation is made and!comply�vith fhe State Con6actors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 3 �'S <br /> naWre Date <br /> / <br />