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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&CREDIT CARDS ARE NOT ACCEPTED <br /> ��S �JC-LL (7 .A /�i✓ <br /> PROJECT ADDRESS <br /> /���' ���,�P ��✓Sa/ / i ��� GU� S�ao/ <br /> Owner Mail Address City Stale/Zip Phone <br /> I Tenant Mait Address City Stale/Zip Phona <br /> 1�,� � � <br /> Electrical Cor,tractcr Mail Address Ciry StateRfp Phone <br /> State License Nun,ber Conlract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of 1Vork to 8e Done: 7 � -� �G (� /� ,S'(J�1/�/��J <br /> � C� hC� �S <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED 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�e�d and examined this application and know the same to be true and <br /> correct. FN provisions o(/aws and ordinances govemmg this type o(work will be complefed <br /> whether speci6ed herein or noL The granfing oI a permd does not presume to give authonty to <br /> violate or cancel fhe provisions o/any other state or local law reguleting constroction or the <br /> performance of construcLon. That I am authonzed by the owner of this propeRy to perform the <br /> work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��.� � �C�---._ �- 3 � - �s <br /> Signamre Dare <br /> � Jv�' l7 � <br />