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l' <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT g CREDIT CARDS ARE NOT ACCEPTED <br /> l D I 0/ Fl v��iC C�r a"a,✓ !v/�� <br /> � <br /> PROJECT ADDRESS <br /> �l� � ��UG �-I J'/ v�� <br /> Owner Mail Address Cily SWIelZip Phone <br /> Tenanl Mail Address City Stateq/Zip Phone <br /> /�f�C <br /> _ f{- L f !'J/-/ /? L (�c� i /'?C C �(J� (�Gn �l/d �y�"i.i I.cGJ, ���If�/ ,CG ��G ?"/��G <br /> ElectriCal Contraclor Mail Address City tate/Zip Phone <br /> fE� � Il ` �.� �// L � /U u �, <br /> State Li:ense Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: Pl?ti �'����Z 1U6�� <<U /1l7/� s✓l�v� c`2 T° <br /> .Si C /`� <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 here6y certi(y that/have read and examined this application and know the same to 6e true and <br /> correcL All provisions ol/aws�nd ordinances goveming th�s type oI work will be completed <br /> whether speci6ed herein or noL The granting o(a permd does not presume to give aufhonty to <br /> violate or cancel fhe provisions ol any other state or focal law regu/ating construction or the <br /> peAormance o!construchon. Thaf I am authorized by the owner of this property to perlorm the <br /> work Ior which application is made and I comply with the Slate Confractors Law 18.27 RCW and <br /> 296.200 WAC- <br /> � �. <br /> �� � �� � � ,S'A/�/ (� <br /> Signature Dare <br /> �C) � �` - .)J <br />