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( ' <br /> ELECTRICAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERElT, 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 /v 5��� �1,rtii�� �v���� l�R �1�'�D � <br /> PROJECT ADDRESS <br /> , / <br /> �1� �D�� S�Y�2t,��.; �� ;�<<_.�e��S�/1��'�iIN�> GU� l�/S� <br /> Owner Mail Address City SWtetip Phone <br /> Tenant Mail Address Ciry StateZp Phone <br /> _�� �-�„� a-T �� ���,��� <br /> ElecMcal Contractor Mail address City State2lp Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Revie v) <br /> Description of Work to Ba Done: <br /> �% .�✓�i{/1'J9.C� ,L ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR.4C CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceMily that/have read and examined fhis application and know the same to be true and <br /> correcL AN provisions ol/aws and ordinances govemmg this type ol worlc will be complefed <br /> whether speci6ed herein or not The granting ol a permd does not resume to give authonty to <br /> violate or cance/the provisions ol any other sfate or local law reguPting construchon or the <br /> perform�nce o( onstruchon. That 1 am authonzed by the owner o/this property tc perlorm the <br /> work fo w ch pplication is m e and I comp/y wdh the State Cor�ractors Law 18.27 RCW and <br /> 286.20 � . �. �;� <br /> \� .���� ' ��� ���� � <br /> a- �s �, <br /> ' �gnaWre Oate ��� � <br /> � <br /> � <br />