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/ . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV�RETT, 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�2 D S a I�,v� pr� Dr. E�er-r:-t k w �_ �r 8 z �-3 <br /> PROJECT ADDRESS <br /> �`�s�a-9o -s S8 <br /> �L�V1I"1 C � l.-C1 � CS /„1cOS � �1/M(7lG I-t'. �✓P�C�+ I.(JG �}gZ`�3 <br /> Owner Mail Address Ci y State2ip Phone <br /> Tenant Mail Address City State2ip Phone <br /> Eleclrical Conlraclor M11ail AdAross City State/Zip Phone <br /> Slale License Number Contract Price of Work <br /> Proposed Use o(8uildin� Conlact Person (Plan Review) <br /> Description of Work to Dc Don�: �i � ��l t 1"1 Q � � '�I� <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 cmti!y fhaf I have read and examined Ihis.,pplicalion and know the sarne to be true and <br /> curecl. AU provisions ollaws and ordinances goveminy fhis type ol work will be completed <br /> whelher specilied herein or noL The granfing o/a pernnt does nef presume fo give authonty fo - � <br /> violate or cancel Ihe piovisions ol any other state or local law regulafing consWcfion or the / /�/J// �7 <br /> peifermm�ce ol consiruction. Thaf(am a�dhorized by fhe owner o/fhis property to peAorm tbe ,_ �l- !L ��C <br /> �vo�k lor which application is made and 1 compty n•ith the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �.l-'i_1�.,.�C_ �G�� n <br /> Si�nature Dale /��� <br /> ��'�' <br />