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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �( — S� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CAROS ARE NO'f ACCEPTED <br /> 'y' � ``� H�'��� <br /> PROJECT ADDRE3S <br /> ��c-�r�= :i;,vc-�r �cr.,�i Po l�o�' 3c� I)c�vi3l� tv1� 9���Iv (�e �� �iy-7y/3' <br /> Owner Mail Address City StatelZip phone <br /> Tenant Mail Address City SlatefLip Fhone <br /> /`iC LrIJTV /'�-�—'L . C`G �NL <br /> EleCtriCal Contracto Mail Address City Statel7Jp Phone <br /> /ll� C�l�'i= �-� i� 3�L J <br /> State License Number ConVact Price of Work <br /> J ' <br /> /- '� <br /> Proposed Use of Bui�ding Contact Person (Plan Review) <br /> Description of Work to Be Done: / ' �; l; �� �% � T�=�1-%f� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ' BE IN RACEWAYS, MC OR AC CABLE. �� 1 <br /> ,�5 �� <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby ceRify that 1 have read and examined this application and know fhe same to be true and <br /> I correcf. All provisrons of laws and ordinances goveming thu type of work wi/l 6e completed <br /> whefher speci(ed herein o�not. The grantrng ol a pe�md does not presume to give authonty to <br /> violate or cancel the provisions of any other stata or/ocal law regu/ating construchon or ihe <br /> pedormance o/conswchon. rhat I am authonzed by the owner of thls property to perform the <br /> work/cr which application is made and I ccmpty�aith the State Contractors Law 08.27 RCW and <br /> 296.200 VI�AC. <br /> �� ,/ 5i'S - D S <br /> -=�=��'� �' � �, <br /> i9 aWre /^ ��.. -j� i �atfl <br /> � <br /> E C75G�-i- GI f� <br />