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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3 _g.-o 5 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �$0 3�045 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> �APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � 3 lo� �,�e �v�e�T, ,,v� <br /> PROJECT ADDRESS <br /> OWner Mail Address City State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> �.s Irff'PR�1�'���-L 0 D. �� 7�_�.�c �i A.�a,1 .c1�} �� 3�� <br /> �ectrical Contractor Mail Address �il State2ip Phone <br /> Us;� 1�'1TS �i q Z L�S <br /> State License Number Contract Price of Work <br /> tb(�-. �►ri�i� C� i,2 <br /> Proposed Use of Building Contact rerson (Plan Review) <br /> Description of Work to Be Done: �cl/`� \ pt`r� � � 'F�t� UD/�+2 � ��/`� <br /> . <br /> i,»� R.�� L C�r✓ C�9.h�e <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> $133. SO <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi/y that I have read and examined fhis application and know the same fo be tnre and <br /> correcL All p�ovisions ot/aws and ordinances goveming this type o(wcrk will be completed <br /> whether speci(ed herein or noL The granting o)a permrt does notp resume to give authonty to <br /> vrolate or cancel the provisions of anv other state or local law regu/ating unstruchon or 1he <br /> peAormance o/construchon. That!am authonzed by the owner o(this p��perty to peAorm the <br /> �vork 1or�vhich application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 AC. <br /> � � �r�J� <br /> ignature Date <br /> s 7� 3 �- �S <br />