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ELECTRICAL PERIIlIIT 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 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � a a� L�,M 5� �fi_ <br /> PROJECT ADDRESS <br /> �v��v bo /�. ` �v a - a �y �� /�/. Su/ ��Jr�wr,� s^�S�oz oa <br /> O w n e r Mail Address City Stale2ip Phone <br /> �/� C r,v�,�.� <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> �y2AEMi,� �ZL-��� �'r� . �p�c 9�S ���t�S zo6-Syz-o�� <br /> Ele.:tncal Contractor Mail Address City Slate/Zip Phone <br /> �'' 1 � 1� i1,� � � � -� -� � � <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �UU�'��P �V i CQ— C�/'�(/�/Vt.=, D <br /> �.� <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 here6y certify that I have read and examined this applicalion and know fhe same to 6e true and <br /> correct. A/I provisions of laws and ordinances govern�ng(his fype o(work will be completed <br /> whether speci6ed herein or noL The grantrng o/a perm�f does not�resume to give authonty to <br /> violate or cancel the provisions ol any othe�state or/oca/law regu/ating construction or the <br /> perfo�mance of construct�on. That I am au •� �ed by the owner o/th�s property to peAorm the <br /> work/or which application is made and I ce .,,ry with the State Contractors Law 18.27 RCW and <br /> 296.200 AC. <br /> c.���i C , � �l .� Q --O c� <br /> S� naWre Date <br /> �� ��y-��� <br />