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i <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 8 CREDIT CAI2DS ARE NOT ACCEPTED <br /> � � I � r1 � <br /> �ZS-' <br /> P OJECT ADDRESS <br /> ZS� — <br /> �s��Us S � (, � � 13 � � ��n� �v �L� � G�sz <br /> OwnS� Mail Address Cily State2ip Phone <br /> ��� <br /> Tenent Maii Address City State/7Jp Phone <br /> ElecMc I Coniractor Mail Address Ciry State/ZJp Phone <br /> State License Number �ce of Work <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Oescription of Work to Be�one: � �C� �- � ^�S \ 1 D� A � <br /> � l�t n�P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily haf I have read and examined this applicaUon and know the same to be true end <br /> correct. All pr isions ollaws and ordinances goveming this type of work will be completed <br /> whethe ec�i d herein or not. The granting al a perm�t does not presume fo give aufhority to <br /> violate cr nc /the provisions of any other state or local law regulating constructfon or the <br /> perfo an e% /constnictior,. T.hat!am authonzed by the owner of this property to pedorm the <br /> work! r h'� application�s made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200�� <br /> �� � � � a s <br /> /G — Oate � <br /> Signature <br /> ��� s--v / -da5 <br />