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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 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> !Co2� �-�o`�� <br /> PROJECT AfiDRESS <br /> 1 a -ti- �J�1�i����rJ s�M� . — __—�;�1��� z�-�3s-zz Z <br /> Ownef Mai!Address Cily Slate2ip Phone <br /> Tenanl Mail Address City Slale/Zip Fnona <br /> �11�e�1 C,�o�,���� �L�����.� zy�� ,.It �U3�<� Se�-r`�wA 2``Uz-,�:�� <br /> EleGrical Conlractor ' MailAddress � I � Ciry SlalelZip �g� 2Lj Phone <br /> U�' <br /> )�E��GG��I�� 1�� 11 ! c�c� �� <br /> , <br /> Slale License Number � Conlract Price of Work <br /> S t d��ll P ����1�L��s l� v`1�11 t �� �G� Cn�`'�c�'� — <br /> Propose�'Use of Buil— ding � Contact Person (Plan Review) <br /> Description of Work to Be Done: �����1�L� �CY'� `�� \l ��� � �� <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 hereby certily thaf I have read and examined this applicafion and know Ihe same fe Ge true and <br /> correct. All provisions ol iaws and ordinances r�cverning this l ype ol work will be complefed <br /> whether speci/�ed herein or noL The granfing o/a permd does not presume fo give authonty to <br /> viol3le orcanoel fhe provisions olany other siafe or local law regulating construclion or fhe <br /> peAomiance o/consfrucfion. That 1 am airthorized by the owner o(fhis properiy to peAorm the <br /> woik lor which qppiicafion is made and I compty wi(h fhe Stafe Confractors Law 18.27 RCW and <br /> 296200 WAC;� i <br /> i, � � i <br /> ",,'--�-: '�'� � �� -�g - � ,;�I <br /> Sig, Nre �,,�i ��' Dale l� <br /> J � ��� <br /> � ��./ <br /> T <br />