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ELECTRICAL PERMIT APPLICATION ; <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 320G 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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 3 ��3 .� j5� ��. <br /> PROJECT ADDRESS <br /> �N,sc c-;���NS 4 ��v -�zN� l��Q sw ��w s�A q��16 <br /> Owner Mail Address Ciry Sfate/Zip Phone <br /> Tenant Mail Address City State/Zip Phona <br /> (�`(�l�M i ,� �Z�U�2CC QD goX ��S �l'�M.�S Sy�3 y� <br /> Electrical ContraCtor Mail Address City State2ip Phone <br /> t' ��lk/v � C (U �� �,LV�.� $�• <br /> State License Number Contract Price of Work <br /> Propos�U��ilding Contact Person (Plan Review) <br /> Description of Work to Be Done: � " '�'�'v ' '" `-( G� � " �� �/�e �/ `� � �� �� <br /> �N�o✓� �-P �-e/l��'�-l/1 <-�ll� <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 certily that 1 have read and examined this application and know the same to be true a.�d <br /> correct. All provisions ollaws and ordinances governing this type o/work will be completed <br /> whether speci�ed herein or not. The grenting of a permd does not presume fo give authonty fo <br /> violate or cancel fhe provisions olany other state orlocal la�v�egulating construchon or the <br /> peAormance of construchon. That I am authonzed by tne owner of this properly to perform fhe <br /> wcrk(or which application is made and I comply with the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ����-- �L� Go- ��t-U� <br /> Sig ture <br /> Date —� <br /> �oy�G -Q&p <br />