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� <br /> 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8510 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �j z.`tj E /�"lctl��,�/z L�rr�J �ri �� <br /> PROJECT ADDRESS <br /> 2UE, ?irI �''� <br /> �ji,�._.+L� l�J ��s� �izv- '�Z� G /�/c<i ,�J� �/��,✓!�_ 'G:�e�t� ��l,z}- `I��l <br /> Ownef Mail Address City State2ip Phoae <br /> C�L'.J NeC'� <br /> Tenant Mail Address City State2ip Phone <br /> O U-�(�'e�- <br /> EleCtrical Con1��Ctor Mail Address Ciry State/Zip Phone <br /> State License Number Contracl Price of Work <br /> Sr � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnplion of Work to Be Done: <br /> 1 <br /> /��F'.�CJL� �j/Y1 � � �/ ��,��/'c}.��,�-� 11tL� �� ' � i <br /> 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 certily that I have read and examined this application and know fhe same to be true and <br /> correcL All provisions ollaws and ordinances governmq Ihis type ol�vork�vill be completed <br /> whefher specilied herein or noL The granting o(a permd does not resume to give au(hority to <br /> violate or cancel fhe provisions o/any other state or local law reguPting consWc6on or the <br /> pe�fomiance ol construction. That 1 am aufhorized by the owner of this property to pedorm fhe <br /> �vo�k lor w/�ch applicafion is made and 1 comply�vifh the State Contractors Law 18.27 RCW and <br /> 296.240'GVA,�. <br /> � ��' � � �- � Zy � , � ' I•�,� <br /> �j'3`ign ture � �� ate <br /> �� ��� <br />