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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 /> , � E aE. r / 0,1_ C-�i22. ,, y°—/ <br /> PROJECTIADDRESS (1 (/o,I- .; E , A--.IL;•� L� <br /> e.), ,........3 . <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �7 (1, !'�/c.c_k,c D . gv.� 1 ef6 3�4 far /9gZs 3 364-7a"?-os 3 55'_ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> I <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: .3k-S i14;l?/4--,4%e,.. e,,—a(,2 ) ,,c . - /a LI- pare S i Cam-..),c4,-7 <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 that I have read and examined this application and know the same to be true and 1 , ( '( '0 <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authorityto <br /> violate or cancel the pl rovisions of any other state or local law regulating construction or the <br /> performance of con tructron.' That I am authorized by the owner of thisroperty to perform the <br /> work for which a ,'cation is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 0 <br /> 3,7 <br /> ature Date <br />