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� .. <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 <br /> ��C�,� 3 y �`' D� �'� <br /> PROJECT ADDRESS <br /> �(2,(- <br /> /✓!�r✓�� �OcaSnN `fG0 � 2�l� D� S(= �Zt-a.e�" Gvi�- �(d'Lu� 31�;-�47� <br /> Owner MailAddress City State/Zip Phone <br /> Tenant Mail Address Ciry Slate/Zip Phone <br /> � /i✓D�'k— EZE�,`nr� rIOoY fd'a�` A-,,� nJi �Ero�:/wn GtiN g.f�s y �Iz1 J'PI'�z7;Yy <br /> Electrical CoNractor Mail Address c�ry staterZip Phone <br /> Lin.;�r�-.� yz��vr� �(.r//. <br /> :,� <br /> State License Number Conlract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to 8e Done: (�'(L (';;:Gu�T <br /> NOTE: WiRING IN NON-DWELLINGS IS f2EQUIRED 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 1 have read and exarnined(his application and know the same to be true and <br /> correct. A/l provisions o/laws and ordinances governing this type�l work will be comp/eted <br /> whether speciGed he�ein or noL The granting of a permd does not presume fo give authonty to <br /> violate or cancel the provisions o(any ofher state or local law regulafing consfrucfion or the <br /> per/ormance o(construcfion. That I am authonzed by the owner ol this property to pedorm the <br /> work lnr which application is made and I comp/y wilh!he State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,/) <br /> �/Z����k`���---- ��3� <br /> Signature Date <br /> � OCaD� -/(�`� <br />