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` <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982G1 <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 /> � �"/ 2 P-G'�k5 �r� U� <br /> PROJECT ADDRESS <br /> �� �-�-���E' I-ID IL1�` 4��' S0�-'�&k � <br /> Owner Mail Address City Stale2ip Phone <br /> 1 <br /> I ;ti � ( L���� <br /> Tenant M�il Address , � � � Cily Stale2ip Phono <br /> � <br /> �I�� [Ic��-�r�L u�. i i�i4 �<-t d�l�Je S� PN6 i3'7 ��c�+t �t�z.�' �s 87o S�'� <br /> EleClrical Conlraclor Mail Address Cily Stale2�p Phone <br /> � j0 <br /> PI�O�L L �` ���7 �� 2 <br /> State License Number Contracl Price of Work <br /> Proposed Use of Ouilding Contact Person (Plan Review) <br /> Description of Work lo Be Done: CJ�� �1�1','�' ���"n��L��� � <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 /> 1 hereby certily thaf I have read and exnmined this application and kno�r the same to 6e frue and <br /> correct Al/provisions olla�vs and ordinances�ovemmg this type oI�vork�vill be complefed <br /> whefher specified herein or noL The granting ol a pennd does nof resume fo give aufhonty to <br /> ��iolafe or cancel fhe�rovisions o/any ofher state or local law reguPting constnicfion or fhe <br /> peAormance ol consfruction. TBat 1 am aufhorized by Oie owner o/fhis property to peAorm fhe <br /> �verk lor which application '�ifade and I comply with fhe Sfafe Contractors Law 18.27 RCLV and <br /> 296200 WAC. <br /> �/��`�- �- 7-GS <br /> Si9naWre° Dale <br /> ,�PSGN-0LS <br />