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ELECTRICAL PERMIT �►PPLICATION <br /> CITY OF EVERE�T PERMIT SERVIC�S �� _�Z_o t� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � � y��`D73 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTE� <br /> ��U � � ��2 W/7T <br /> PROJECT ADDRESS <br /> (��s) <br /> �/l�ti c.-� iN��s7n,tZ�rrs �L� �YNNWvai) (n�k `i�3� 6��-�/i& <br /> Owner Mail Address Ciry Slate/Zip Phone <br /> ienant MailAAdress City SlatelZip Phone <br /> Qb✓/V� /�UCf��i/1 <br /> Electrical Contractor Mail Addressc Ciry State2ip Phone <br /> �-�_—_ <br /> �.3� n-z7� <br /> State License Number Contract Price of Woric <br /> ���//�� /+'�'- l_C)ri.'�� ��O/�7�^�{'ly�'.C'� �iC�Q/5 /-<A�` <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> �..7� S�• �� <br /> � F/ � <br /> Description of Work to Be Done: � f ` ��- � �� � / ' �' �''e— <br /> �J ' <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 certify that I have read and examined this app/ication and know the same to be true and <br /> correct All provis�ons ol laws and ordinances goveming this rype o/work wlll be comp/eted <br /> whether speci6ed herein or not The granting o/a permrt dces not presume to grve authonty to <br /> violate or cance/the provisions of any other state or local law regulating construchon or the <br /> peAormance of construction. That I am au(honzed by the owner o/this property to perlorm the <br /> work lor which application is made and.l omply with the Sfate Contractors Law 78.27 RCW and <br /> 296.200 WA�- � � � <br /> � <br /> � �;',� % - " .�� a � <br /> Signawre /� D re . <br /> y�l- I:� <br />