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�- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �I - �Z'�y <br /> 3200 CEDAR STREET, EVERETT, VyA 98201 �����07 y <br /> 425-257-8810 - FAX 42 i-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDR CARDS ARE NOT ACCEPTED <br /> ��� �i�s�� �G�"� L9t <br /> PROJECT ADDRESS <br /> -��„�-- ,�.�� ��c�E�-���i� /99ao �w� 99 �� <br /> py,met Mail Address Ciry SfatN7Jp Phone <br /> �/'✓J'✓GfJ� �t/�'i 9�,� <br /> Tenant Mail Atldress Ciry Smte/ZiP P�o^° <br /> (��,v,�}"���'!�! .��� <br /> Electrical Conhactor Mail Address Ciry Sqle2ip Phone <br /> 8c�_o� <br /> State License Number Contract Price of Work <br /> ��✓c�ss in.�l� �iC��/S ,�/,Cc.G (:1�2s�f'� `7l dO <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �� S;,� <br /> Description of Wark ta Be Done: ��—���.�°/�QC /JJ/�l�L. /� �l��N <br /> .b�� �-, r��f S <br /> NOTE: WIRING IN NON-DWELLINGS iS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I nereby certily thaf 1 have read and examined this application and know the same to 6e hue and <br /> conect. All provisions of/aws and ordinances govemmg this type of work will be.completed <br /> whether speci�ed herein or noL The grantir.g ol a permd does nof presume to grve authonty to <br /> vio/ate or cancel the provisions o(any other state or local law regulating construction or the <br /> performance o/construction. That 1 am authorized by the owner ot this property to peAorm the <br /> work/or which applicatiort is�@de and I co ply with the Sfate Contractors Law 18.27 RCW and <br /> 296.Z00 WA � <br /> . � <br /> Signature Da <br /> ��- 7l/ <br />