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1 <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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 7 o d G.: ,^,f�� .� ,� , �, t'J r <br /> PROJECT ADDRESS <br /> /� i(.c.... F � 7'��'A/'�.S �t I <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City StatefZip Phone <br /> �7�� � ��. � .( , , � 1_-� � �r <br /> Electrical Contractor Mail Address Ciry StatelZip Phone <br /> State License Number Contract Pnce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: �.���„ .� ,�/,G„i /�D yr� � <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 ceRily that I have read and examined this applicafion and know the same to be tnie and <br /> correct. All provrsions o/laws and ordinances governmg this type o/work will be completed <br /> �vhether specr6ed herein or not The granting o/a permd does not presume to qive authonty tc <br /> violate or cancel;he provisions o(any other state orlocal law regu/ating construction or the <br /> peAormance o(construct�on. 7hat I am authorized by the owner o(this property fo pe�lorm the <br /> �vork lor which appliwtion is made and I compty wdh the State Contractors Law 18.27 RCW and <br /> 296.200 4VAC. <br /> �/�C .-f i- /��/1/G / <br /> ,.�� signawre Da � <br /> 4//- 5Z <br />