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t k <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 />4 �5 7 ✓✓f51A PL EI1e—sefi <br />PROJECT ADDRESS <br />`1 9>"7 j/ sfg PC T�eTrt 1 G%y a�'2o3 ?Sb'3Yr8 <br />Owner Mail Address city State/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />Slate License Number Contract Price of Work <br />Proposed use of Building / Contact Person (Plan Review) <br />Description of Work to Be Done: .2 00 ij�/) <br />7/ilAi�✓ �c� ^^ D/�N�� �>' — <br />U�>C' nv n %,t-1 xjra /1 oe /-lr'.L,) 2 9.fiA ,Co[i i <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE ��� 40 <br />BE IN RACEWAYS, IAC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. / <br />Signature Date <br />136 <br />