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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.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> G v�� �GMI�r�� �v�n�� <br /> PROJECT ADDRESS <br /> 0/)C c��a�k Z03� /�,m(�a,-c�,�fve. �vere�-� 1A�� �/25�13/-6�Y�3 <br /> Owne� Mail Address Ciry State2ip Phone <br /> Tenant Mail Address City Slale/Zip Phone <br /> �JWn1F� <br /> Electrical Contractor Mail Address Ciry State/Zip Phone <br /> State License Number Contract Price of Work <br /> uoM� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �el�ilrt', �O;v�¢- I✓I �r�Qf Y'� MP� N��. . <br /> NOTE: VVIRING 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 certily ihat 1 have read and examined this applicatron and know the same to 6e true and <br /> currect. All provisions of laws and ordinances govemmg this type of work will be completed <br /> whether speci�ed herein or noL The granting of a permit does not presume to give authonty to <br /> violate or cancel the provisions ot any other state or/ocal law regu/ating construction or the <br /> perlormance o(construction. That 1 am authonzed by the owner of this property fo peAorm Ltie <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �/�C� l�!,��r,�/ /0���a y <br /> Si ature ate <br /> �c���D —U�J <br />