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i ` <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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �U ��'� � �L S% <br /> PROJECT ADDRESS <br /> ��ii7i� �' / / � �57�/Lf� o.;-. �� 0 �;�,.- �� �� G'P/Y"Gd�l <br /> Owne—r T Mail Address City State2ip Phone <br /> Tenant Maii Address Ciry State/Zip Phone <br /> 3�U <br /> ��-.-rr�s ,�.��� `����,�r � �..3���� ,��,�,.�/�, �� ���>3 �'-�'-�=�,�,1 <br /> Elechical Contraclor Mail Address City Sfale2lp Phone <br /> /��c�� �:IL ��,.�� <br /> Slate License Number Contract Price of Work <br /> S�"2 <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Done: (�/i � "�S �7 /f'�"w �rr��i'�r' �U�f� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 55`�' <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 <br /> 1 hereby certi(y ihaf 1 have read and examined this application and know the same to be frue and <br /> conect. All provisions o/laws and ordinances governiny this type olwork will be completed <br /> whefher specified herein or not. The granting of a permd does not presume fo give authority to <br /> violate or cancel the provisions olany other state or local law reguleting construcfion or ihe <br /> peAormance o!construclion. That 1 am aufhorized by ihe owner of this property to perform the <br /> work lor which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> C���c"�� ��,�;�•-� 7— //-�� <br /> Signature Date <br /> COSa? -G�{Z <br />