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� 4 - <br /> ELECTRICAL PERMlT 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 /> i , .,c� <br /> l �`� �'� / � l�uS7���1 � - - -,�, <br /> PROJECT ADDRESS <br /> Ownef Mail Address City State2ip Phone <br /> / � -�- L � �z`` <br /> Crr t. � � �! `t �G X QV ��OS� /3 ��' S��d.30c� ��G�iiz/T�%J 1��O/ Zq�-vJ43 <br /> Tenant Mail Address City State/Zip Phone <br /> �t-c.,��t �l Cf��1���_, � ✓1 C �D I�aX /(S � /�G��,�r L l�'d /�/) �j'�7 7 1 <br /> ElectriCal Contractor Mail Adtlress City State/Zip Phune <br /> A(e.tv. �E=� r i s� J � �/2n��. ��� <br /> State License Number Contract Price of Work <br /> C.�!,;I,r< ',Q-��� C � I�t �+i/<"dS <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dane: i� G 1J( <<� ��� I)� 1 U ��'� ��r'�S" <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> C�TY OF EVEi2ETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby r,e,7iiy that I have read and examined rhis application and know the same to Ge true and <br /> correct. All provisions of laws and ordinances goveminq this!ype of work�vill be ccmplefeti <br /> wheth,er speci/ied nerein or noL The granting o(a permd dces not presume to give au(hority to <br /> vidate or cancel the provisions of any other state orlocal law regulating construc6on or the <br /> I pzAormance o�construct�cn. That/am authonzed hy the owner o(this propeRy to perform!ne <br /> �vork(or which,�application is made and I comply with the State Contraciors Law 78.27 RCLN and <br /> 296.200 WAQ. <br /> r /' C �\" �t ��- � �f_ �� � <br /> } <br /> , /Si9naWre Oate I <br /> I _/(; L� — , � <br /> � <br />