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ap <br />` <br />ELECTRICAL PERNiIT 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 />� ( ( � la���-�- <br />PROJECT ADDRESS � <br />�1 ��,��� u; ��:.� �l i � [-(a._, �- E��- w r=1- �-t�zx� I _ <br />Owne� Maii Address City Slate/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />I��I�V1 { lf� �L'iL- 2`il(c 1'W'�=. �';t I�./%. GJI�' `f2i-252-`1907 <br />Electrical Contractor Mail Address City StatcaZip Phone <br />��a���r-_c-�io'��.-)Z <br />State License Number <br />�� � <br />t�l� �� i;t,�,�t� =� <br />Proposed Use of Building <br />Description of Work to Be Dane: ��= C-�r,; l�. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1, <br />`b� iCiiC,� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />��t��c�c- r"��� <br />1 hereby certify that 1 have �ead and examined this application and know the same to be true and <br />conect. All provisrons of laws and ordinances govemmg (his type ol work �vill be cemplefed <br />wnether speci6ed herein o� noL ,The granting o/ a permrt does nof presume to give authority to <br />violate o� cancel ihe provisions olany other state er local law regulating consfruction or the <br />perfo�mance o! construchon. T'hat 1 am authorized by the owner o( ihis property to periorm th,e <br />work (cr which application is made and 1 comply :vith the State Contractcrs Law 18.27 RCW and <br />296.200 WAC. <br />� L . ,.ti. � (�� <br />"L- I `i �'� `7 <br />FEE <br />�� <br />�-�•? _�� �� <br />�, _ _ <br />