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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 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> i � ly 1P � �� s� <br /> � <br /> PROJECT ADDRESS <br /> ��f� � 4 � �I P�-�� Fv��' '�,r� _ �Ix'-�� - <br /> Owner Mail Address Ciry Statel�p Phone <br /> Tanant Mail Address City SWIe/TJp P�one <br /> >� �c�.�l CR� �1Mf�4 �`3U�1 �f`�t )$?� v��u �4.'�rnc�r� �..i �i q�G�B�` <br /> ElecVical Contractor ail Address Clry State2ip Phone <br /> ,�t�.-�-L�S� ��\3a� � .1 ,�i 4� �``' �s-v�} � <br /> State cense Number ConV t Price of Work <br /> \v�'N�� ��(/�C J ! <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: � �'l� ������ l l` \a ��� <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 that f have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this fype of work will be completed <br /> whether speci�ed herein or not. The granting o/a permit does not presume to give authority to <br /> violate or cancel the pr�visions ol any other state or local law regufating const�ucfion or the <br /> peAormance o/const�uchon. That I am authorized by the owner of this property to peAorm the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> zl�Sign t e � Da[e � � <br /> ,Eo�}og-d5� <br />