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i <br /> t <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 /> /`/��7 �9�r.. � T% <br /> PROJECT ADDRESS <br /> I�' f�. J �KJ�/ I U l�x ZZ L�� SC�a-f�/If (.t../a- q�� 'ZL <br /> Owner Mail Address Ciry SWte21p Phone <br /> 2� Pp�s Jtv<� C�.,,,He �''�-�?,tt" c.r�a- 982� � <br /> Tenanl MailAddress City Stale2ip Phone <br /> OlJNe� 2 G�` %3u�eV�(N�� <br /> Eleclrical Contractor Mail Address Gty State2ip Phone <br /> � /OUJ � £'j, <br /> State License Number Conlract Price of Work <br /> R�"—G(S£' d�' �d F�f� �5/�ta P /�EIZr �ll�i f <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: ��� C//< <� �'i J � O�T��S TJ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� S/j <br /> (� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certilv fhaf I have read and examined fhis application and know the same fo be frue and <br /> correcf. All piovisions o/laws and adinances goveming fhis type ol work will 6e completed <br /> whether speci6ed herein or noL The granfing of a pemut does not presume to give aufhonty fo <br /> violate or cancel fhe provisions oI eny other sfate or local law regulating construction or fhe <br /> perfonnance o/construcfion. Thaf 1 am authonzed by the owner o/fhis property to peAorm fhe <br /> work Ior whicb application is rnade and 1 comply wilh fhe State Confractors Law 18.27 RC W and <br /> 296.200 WAC. <br /> ,� - /3 - ��,� <br /> Signature Date <br /> � �o� � <br />