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ELECTRICAL �ERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPT'cD <br /> llG/lq �y7��q��. S�. �-/ oz <br /> PROJECT ADDRESS <br /> ���7�adiN I��v, (?v, f3'x /as5 s�l,oh�s� GrJ�. `�'�Z9 / <br /> Owner Mail Address City Slate2ip Phone <br /> /-�ht��a?� �l'If�1�ShOr° <br /> Tenant Mail Address City State/Zip Phone <br /> �q�� s�Rurc� ��%Lti�r� /�zos f�u/ wy s�hahisb l�/�. �g29/ Zt�-3� -a�o/ <br /> Electncal Contractor Mail Address City State/Zip Phone <br /> (��-LS�� .L IZJL-Iv' Lf� od �-o <br /> State License Number Contract Price of Work <br /> 1 a�z1 i� �G����%r'�n./ <br /> Proposed Use of Building Contact Ferson (Plan Review) <br /> Description of Wark to Be Done: /l✓»j L�— /�D� 51'�ILU I GT�_ �i(SH i S � O��'j�. <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 certify thaf I have read and examined this application and know the same to be true and <br /> correct. All provisions o/laws and ordinances governmg this type of work will be completed <br /> whethe�speci�ed herein or noL The granting ot a pemtd does not resume to give authonty to <br /> vio/ate or cancel the provisions o(any other state or local law reguPting construction or the <br /> per/ormance of construchon. That 1 am authonzed by the owner o/this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `� �� �-- o�� 3-0 <br /> � SignaWr Date <br /> i <br /> � Oy�G-QS� <br />