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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 � � — �' —D% <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� ?�`�_�j i <br /> ��'Z5S_`�{'' �� SW L �c��.l,'c c,c1s� R67r.3 <br /> PROJECT ADDRESS <br /> '-: 2r� _ <br /> SoN (l,� S:.x��e � � l rt�'t�AL.I� l�v� �V��TT WI� �lOZA3 �37 -Lyll <br /> Owne� Mail Address Ci�y StatelZip Phone <br /> Tenant PAail Address City StateiZip Phone <br /> C'�� �9r.�E� — <br /> Electrical Contraclor �.1ail Address City State�Zip Phone <br /> State License Number ConVact Price of Work <br /> Proposed Use of Building Con:act Person (Plan Review) <br /> ���Q�5F <br /> r <br /> Description o(VJork to Be Cone: _1,�J� °e, ne�.J � �.,�Q <br /> NOTE: WIRING IN NON-DWELLINGS IS R.EQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat I have read and examined this applicati�n and know the same to be true and <br /> conect All provisions o(laws and ordinances�overnmg fhis type olwork will be complefed <br /> whefhe�speci(ied herein or not. The granting o/a pe�mif does not resume to give authonf��to <br /> violste or cancel fhe provisions ol any other state or local law reguPfing consVuchon or fhe <br /> peAormance o/censtruchon. That 1 am authorized by the owner o/this property fo pedorm the <br /> work Ior which fion is made and 1 comply wi(h the State Contractors Law 13.27 RCW and <br /> 296.200 WAC <br /> , ( / l. ' , � . <br /> `��' ignal fo� 0 e <br /> l� � % <br /> '� � .��7��-0� l <br /> �_, <br />