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. , <br /> � � <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ll ylq l q7b�/� v�S� C ► o� <br /> PROJECT ADDRESS <br /> ��77�R.d� N IJ��t/. (?d,f�oX � oSy S1,k�koh�S N (� c1'�2�/ <br /> Owne� Mail Address <br /> City State/Zip Phone <br /> StG rJ�;tip.� <br /> Tenant Mail Address <br /> City State2ip Phone <br /> Q �c, sFz2����z �i��r2�� �°oL a� Ye'�.w cc�,� �l.�h e11�s�r G�fl .`0�6 ZoG�3`b'9 a/B I <br /> Electrical Conlractor Mail Address Ciry SWte21p Phone <br /> � � �S��d��.� ( Z� � r�l f� oo� ` <br /> State License Number Contract Price of Work <br /> c> J� f- �Gl�� �LfC 1 dlt.o!�r-� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �escription of Work to Be Done: � � NI� N i �jU (L p U U � �—Q�L �.Kyf,L �,R�'�_ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certi/y that I have read and examined this application and know the same to be true and <br /> correct. All p�ovisions of/aws and ordinances governing this type of work will 6e completed <br /> whethei speci6ed herein o�not The granting o/a permrt does not presume to give authonty to <br /> violate or cancel the provisions of any other state or local/aw�egu/ating construction or the <br /> performance o/construchon. rhat 1 am authonzed 6y the owner of this property to peAorm the <br /> work for which application is made and I comp/y with Lhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � � � Z (.S - 0 �", <br /> / Signature Date � <br /> I <br /> E d� �a-a�9 <br />