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, <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 d AM TO 4 PM - DEBIT R CREDR CARDS ARE NOT ACCEPTED <br /> 1C�.3 / /AinJG l/`C /f� �/�� �(�c?t��'i%GcJ/� /�`�C�� <br /> PROJECT ADDRESS <br /> ,� ��/ �� � <br /> �/. C��/yl � � I:C� /3ii✓_ �`��L /�lU/.ILjF� G�B �'`/,�Z7S ytr.s�s�� <br /> Owner � Mail Address City SGteZp Phone <br /> Tenant Mail AtlCress City Stale2lp Phocie <br /> L�C,J,veiL ��O,x� <br /> Electrical Contractor A4ail Aaaress Ciry State2ip Phone <br /> State License Number Contract Price of Wortc <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��G �'j,C!C,.F� i,✓s7oL,aT`.9,✓ /`�lin-. �/% Tdd'� <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 ceRi/y that I have read and examined this application and know the same to be hue and <br /> correct. All provis�ons ol/aws and ordinances govemmg this type ol work wi/l be completed <br /> whether speci�ed herein or not The granting o/a permrt ooes not presume to give authonty to <br /> violate or cancel the provisions ol any other state or/ocal law regu/ating construcbon or ihe <br /> periormance ol construchon. That/am authonzed by the owner o/this propeRy to peAorm the <br /> work Ior which application is made and I comp/y with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> % <br /> '�� �, / �,� /- �_.3i-�� <br /> ' Signature ' Date <br /> EO�ta�i-I�I <br />