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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ,a�, �-oy <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � ����O7� <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 /> / �O� �J✓'� �J r�U� <br /> , /' <br /> PROJECT ADDRESS <br /> t�,�i- �.z�._ <br /> ���• * /`1 c c G� � � '�C G�,� �� �-�,,"_,� c.��- �ra , ' <br /> Ownef Mail Address City State/Zip Phone � <br /> ��- � <br /> / <br /> i <br /> Tenant Mail Address City State2ip �e- <br /> �� w�� (i2..�Nc....,� Gs(s ((�'� o<< f� s;�i�.--« I-l- iL„�9- , <br /> Electrical Contrector tvtail Address City State�Zip phone <br /> i <br /> r/�.(c/ U � (�l77�� �c�., �- <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Wark to Be Done: f��r[v�� �/rC'�'�'-e '— �J�7(1'•"7.�' F^�"� L '— <br /> 1 �(RC� iri r- Nc'�✓ ���`� <br /> � � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, ti1C OR AC CABLE. <br /> i <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certify that 1 have read and examined this application and know the same tn be true and <br /> conecL All provisions of laws and ordinances g,:veming this type o/work will be con,leted <br /> whether specihed herein or noL Tne granfiny ol a permd does not presume to give avth,ority to <br /> violate or cancel the provisions of any other state orlocal law regu/ating consWction or the <br /> performance ol construchon. That 1 am authonzed by the owner ol thrs propeRy to peAorm the <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> i 296.200 WAC. �. <br /> ' �(j, , l, �� � � �-- ���- �.� <br /> Signawre Date <br /> /-���I �L_ <br />