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ELECTRICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI', 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 /> LaT 3; N3L N6`hs�_s�. <br /> PROJECT ADDRESS <br /> �ti l� pRB�CRFC/G �LC <br /> Owne� Mail Address City State/Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> �?c�) <br /> �i���� Mr���2 i�GF_C N�Z� S�o�N,��-,�.�R v� %/L�.EL4n�D WA. �vZY9 "33/, 7s7Z <br /> Flectrical Contractor Mail Atldre,s City State2ip Phone <br /> YIEVINME9i/n1� <br /> tate License Number Contract Pnce of Work <br /> �-[�Slr�fv1� i�. � <br /> Proposed Us of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �,�I( ��15 D�+- ��� �^�G J f�� <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 /> 1 hereby ceRify thaf I have read and examined this application and know the same to be true and <br /> correcf. All provisions ol/aws and ordinan�es goveming this type o/work will be completed <br /> wnether speci��d herein or not. The granting of a permit does not presume to groe authonty to <br /> violate or cancel the provisions n(any othe�state or local law iegulating construction or Ihe <br /> performance of cunsvucUon. That I am authorized by the owner o(this propeRy to perform the <br /> werk for which auplication is made and/comply with the Sfale Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> r <br /> ';�-T� � /J�%C ��, �Z 'R � y <br />' Signawre ' Date � <br /> tEc� -lJ/Z " 7� <br />