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� <br /> ELECTRICAL PE:F�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-�57-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PiJI - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> _��.`� I�I L�c�'y �`Qev� (�'Ic�../ <br /> PROJECT ADDRESS <br /> ��,r►ner' I�c���k <br /> Oivner Mail Address City State/Zip Phcne <br /> Tenant Mail Address City Stete2ip Phone <br /> ���. Te1ec�Hov�e yio s u��� s`� S�;k� Sea`�{�� . u�A 'in��� a�����z-59�, � <br /> ElecMcal Conlraclo � � ; � Mail Address City :Wte/Zip Phone <br /> � /- <br /> �C`rLLI '� o�1L1 �^�21�1�� � S60o <br /> State License Number ' ' Contract?rice of Work <br /> ���,Svr � uN�^� �— <br /> Proposed Use of Building Contact Person (Plan Rev�e.v) <br /> Description of Work to Be Done: ��'7S�I oot�h �.G V 1� V�< <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWA.'S, MC OR AC CABLE. <br /> � <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined this applicatien and know the �ame to oe fve and <br /> conect. All provisions o;laws and ordinances geveming ths h��e o/work �iill be completed <br /> :vhether specdied herein or not The granting ol a permd does hot presume to giva authcrity to <br /> nolate or cancel the provisions of auy other srate orlocal law regulating construction cr the <br /> pedormance of c�nstruction. That I am authorized by the owne�o(th�s propeRy to perterm the <br /> :vc;k for which application is made and I comp/y with the Slate Contractors Law 7827 RCW and i <br /> ?96.200 WAC. <br /> c1 �OV� �� (0 y � L <br /> ignature Date <br /> �G`fl�i ' ( ` I <br />