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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 - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> Z 3a& 2 ca '�`'` S� /=�d'r�' <br /> PROJECT ADDRESS <br /> 3+��,ni�. S��A�1 (P�`✓�'�z oh Mia2,�rY, <br /> �A�2�2 v .S`o�—•J �{a� <br /> f Yjl�{ L7AlLCS ,Evt� L1k'�'tF.C/'T wA 9u'ul 25'� 150�( <br /> Ownef Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical ContreCtor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> S��:hc� ��jn«� /1��'iiJc-�✓cC" <br /> Proposed Use ef Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �Es— W��� �2nn��G� (�O� � TU f3� J <br /> y . � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE iT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify fhat!have read and examined this application and know the same to 6e true and <br /> correcf. All pro �, 'ons of laws and ordinances gaverning this rype of work will be completed <br /> whether speci ed herein or noi e ranting of a permit does not presume to give authonty to <br /> violate or can el the provisio ol any oth state or local law regulating construction or the <br /> perlormance (construction. That 1 a ut orized by the owner of this property to perform the <br /> work lor whic application is made a I co ply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> i <br /> 7 2 Za�� <br /> Sign re Date <br /> F o�to� -oo� <br />