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( <br /> ELECTRICAL PERMIT APPLICA�ION <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 8 CREDR CARDS ARE NOT ACCEPTED <br /> s29 _ s� �oN ��ST <br /> PROJECT ADDRESS <br /> TQ �I� SmuY'lnw���k SQ�..e F�tir � wC� • p'��-o� <br /> Owner Ma'I Address City Sfate2ip Phone <br /> �'V � � <br /> Tenant Mail Address City StaM/Zlp Phone <br /> �sy-6a7� <br /> .S�R�'lUY'S�E(ec?`r�c `�Oo ) Sl.ur�'l1 �P I�vereR7 u.�l 9�'�Yoi �v�,�� <br /> Electrical Conlractor Mail Address City Slate/Zip Pt�ne <br /> S�A-l-Fcr E .�0 99'�N <br /> State License Number Contract Price of Work <br /> 1/�e S( c� <br /> Proposed Use of Building Contact Person (Plan Revirw) <br /> Descnption of Work to Be Dane: l�aG�� �,lJ�(c�. <br /> NO�E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> SS• m d <br /> CITY OF EVERETT LOCAL SALES TAX COUE�S 3105 <br /> I hereby certify fhat I have read and examined this applicatlon and know the same to be tnre and <br /> correct. All provisions of laws and ord;nances govem�ng this type oI work will be completed <br /> whether specified herein or nol. The granting o/a permd does notp resume to give authonty to <br /> violafe or cancel the provisions o/any other state or local!aw regulating construcfion or the <br /> pedormance of construchon. That I am authonzed by the owner o/this property to perform the <br /> work lor which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _�_ �i�Pi� �..- 7-- OS' <br /> Signamre �ate <br /> � vsv�ll� <br />