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� <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-885i —www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> L.�_ <br /> ��� L ���� <br /> PROJECT ADDRESS � <br /> �,�, P�-Nl e r�' 7� d5� -l�Z l <br /> Owner Mail Address Ciry StateRip Phone <br /> Tenant Mail Address City StateZp Phone <br /> �/u-�v1-3�y3 <br /> � ��Sbv� ��ec�-f'�C C�.�G� 17 c?E� f�'-�(,�1 ��f�bh wc�a� �37 <br /> Electrical Contractor Mail Address Ciy StateZp Phone <br /> Q�OLSl,N �L�7� I� �I <br /> State License Number Contrect Price of Work <br /> t�2.S��O�N��-� 0.'.\ �\Q.�.� 1�d t�� So� <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description af Work to Be Done: ,tC �J ����_f��,�/ ��pLq 1� �� � <br /> L'—X�Sy il.�c �^�ti''\t� <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 certi/y that 1 have read and examined this application and know ihe same to 6e true and <br /> correct. All provisions o/laws and ordinances goveming this type o/work wi/l be completed <br /> whether speci�ed herein or not. The granting oI a permrt does not presume to give authonty ro <br /> violate or cancel ihe provisions of ary other state or local law reguleting construchon or the <br /> pedormance of construchon. 7hat I am authonzed by the owner o/this property to peAorm the <br /> work for which application is made and 1 comply with the Sfate Contractors Law 18.27 RCW and <br /> i 296.200 WAC. <br /> � Signamre Da��' ��^ O`� <br /> � O�ioq-a5� <br />