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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�� � YYI��C7Nvc-era— 64��F <br /> PROJECT ADDRESS <br /> s1+���-�2� s�-�Y,� �s A�.�E <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> --� <br /> �i�Z��-r��iTL� �G��iz�C J`n i��%x Z`��"� ��'7� c�1a- <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> L ✓c�c ✓i ��-� Z v 3 c.;C �OD <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: _ ���/Gr !�-rtJ�7 �l 1v<���r 1�f.21E ��.�EI�._ <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 /> 1 hereby certify that 1 have read and examined this application and know the same to be frue and <br /> correct. All provisions of laws and ordinances governm�this type of work will be completed <br /> whether spec�fied herein or not. The granting of a perm�t does not presume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �qt.�i/�G�'�!_ <br /> l/C..� �/ <br /> � <br /> Signature Date � � <br /> G'� <br />