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� � <br /> EL�'CTRICAL PERMIT APPLICA`fiION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl-f, 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�L� <br /> � � <br /> �'� `I 6�`` s•; s c 3 <br /> PROJECT ADDRESS <br /> (L S � <br /> O�vner MailAddress City Slace/Zip Phone <br /> Tenant MailAddrees Cit7 State/Zip Phone <br /> I�I�J�..� I"\�\\Cf 2�GC <br /> Electrical Conlractor Mail ACdress City State/Zip Phone <br /> State Licen;e Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: I-��M/' �a I� <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 /> I hereby certi(y that I have read and examined this application and know the same fo be true and <br /> correcL Flll provis�uns ollaws and ordinances governing fhis type o(worlr will be compfeted <br /> whether speciRed herein or not The granting of a permit does not presume to give authoriry to <br /> violate or cancel the provisions oI any other state or local law regulating censtrucGon or fhe <br /> peAormance o/construc6on. That I am authorized by the owner of this property to perform the <br /> work(or which application is made and 1 comply with the State Contrectors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �c� �"/ �� �7 � z 3 - n �f <br /> Sig ature Date <br /> T o4o�-oia <br />