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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF E'JERETT 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 /> � z� � 1'�'1f��w� ✓�e"'� (J '� L <br /> PROJECT ADDRESS <br /> C�-��5 c���s P�b ���zg� �-v�-, w�- �����y2� <br /> 2 3�� <br /> Ownef Mail Address G!y State/Zip Phone <br /> S� � <br /> Tenant Mail Address Ciry Stale2fp Phone <br /> Electrical Contractor Mail Address City Slate2lp Phone <br /> Slale License Number ConUact Price of Work <br /> �v�-�cU <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Be Done: ����"�S ��'T� � S ^�-C� ��' <br /> C.cl`^-l�`���r 7"rcv�-� �-��•.5� �O �`--e. <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 certi/y that I have read and examined this applicafion and know fhe same to be tnie and <br /> correct. All provisions o/laws and ordinances goveming fh�s type o/work will bo completed <br /> whefher speci�ed herein or not. The granting o/a perm�t does nof presume to give authonty to <br /> violafe or cancel the provisions oI any other state or local law regulafing construction or the <br /> perlomiance of construction. Thaf 1 am aulhorized 6y the owner o/fh�s property to per/omi the <br /> work for which application is made and 1 comply wilh the Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> C �- ���-- � l7�� � <br /> Signature Date <br /> F�5 a1-�zS <br />