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ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT pFRMIT SERVICES <br /> 3200 CEDAR STP.cET, 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 /> r' �//% C��,E, S � ��> <br /> PROJECT ADDRESS <br /> � <br /> �`lC��i r i �_ ��_� `��� r�>.sr� 5 ,�.� — <br /> Ownef Mail Address City State!Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> �/�/�Z C'�c i .� „ <br /> � 7�� �� �- .� �,� / .0 i� �L�7 �S� �-GJ /7�c%�;.LTf'n ! '�9�?.7� <br /> Electrical Conlractor Mail Address City StaL•21p Phone <br /> /���jfr ��(�/f/�/r"' --�� i��� w <br /> State License Number Contrar.Price o(Work <br /> Proposed Use of Building C:ontact Person (Plan Review) <br /> Description of Wark to Be Done: /�I�/1RC�t�� � i/� — �La i�� � 7 �� nr n v�� <br /> l'� l" � � %1)�I4� �i=1�ir'C - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, h1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that/have read and examined this apcfication and know fhe same to be true and <br /> correcL Aq provisions ellaws and ordinances goveming:his type oI u�erk �vill be completed <br /> wnether speciGed herein cr noL The�ranting o/a permrt dces notPresume to give authonty to <br /> viclate or cancel the provisions of any other state or Iccal la�v regu�ating construc6cn or the <br /> pertormance oi construchon. That 1 am authonzed by the cwner ot this property to perioim the <br /> wak Por which application is made and I ccmply wdb the State Ccntraclors La�v 18.27 RCW and � <br /> 296.200 WAC. <br /> � �.� ��� �� i�i�=c��/ _ ��� -1 <br /> / �gnawre , Date <br /> � �� �, <br />