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�, { <br /> EL�CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER�TT, 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 /> /%U3 ��,,,,� / <br /> PROJECT ADDRESS <br /> y2�-2s� <br /> -�� c�����, (e /Zc3Gi2Aw�� � �,� �� 9g��� Z�q� <br /> OWner Mail Address City . SWte/Zip Phone <br /> Tenant Mai�Address Clty Stale/Zip Phone <br /> Elect�calConGaclor MailAddress Ciry State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: wl21W G S l)C � f � OG S//) i 1 f�i l <br /> Lv�2� �G /C7LS /��- ar.(�"/3`�i�Dirv� h��u /�� '�7 , <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 3705 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. Ali provisions o(laws and ordinances governmg this type of work will be completed <br /> whether specified herein or not. The granting o(a pe�m�t does not presume�o give authority to <br /> vio/ate or cancel the provisions ol any other state or local law regulating constn�cfion or the <br /> peAormance of construchon. That I am authprized by the owner o/this propeRy to pe�form the <br /> work for which applicatlon'is,�edQ.and I �iVi State Contractors Law 18.27 RCW and <br /> 296.200 WAC. ,� �//' ; / <br /> ��.�' , <br /> � � �%� � � � <br /> /-�.� / / � z a <br /> ! Signature � / Date � <br /> /� i <br /> l <br /> �G�� II n(�� <br />