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/ <br /> . . �- _ ' . . , .- . .`����. �� ', <br /> ELEGTRICAL PERN{IT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA g82�' <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARF NOT ACCEPTE� <br /> �� 1 l, <br /> �` � � I ' ' �; . _ ;{ �. , � �� �� �; , � � �i � ;ti��� <br /> t <br /> PROJECTADDRESS � ��� I���C�� � <br /> �� <br /> '�� �. � � 'tr'i ��'r . I : ; � i� ;, i � i . , �� � � �1 `� 1 �\� � �� ij t (�C� C � <br /> Owner Mail Address y � State2i <br /> Cil P !�� L P7hone .Z, <br /> � i I L i��F'1 ,�, � i . -� ,� ��C-�G � L. � <br /> '�\�'%1 ('� � ( t'�ll��� l� � ���� � � � ���1� �b� �'v' ;�(- :4� ll 1 'I � ( � � � � �. �'� <br /> Tenant MailAddress City State2ip Phone �� �� <br /> / . <br /> �� i�, l� %� i,lr i � 1�V�,i_ '-,I j� l -1"� ��1��� ` � :, � 11�1� � � � � �� ��;� � (2 Cl ��4�L� � ��( <_; <br /> Electncal Contraclor Mail Address City Slate/Zip Phone <br /> � ..� � � _ �� � � . _ I .�,� f ] � �� � . � . <br /> � ��l� �:. �_ i 1 -. �; i <br /> State License Number Coniract Price of Work <br /> i � � , <br /> ;'�' �� � ��� � '� i .'� ( � :' � ' � � �'.f' 1 � � I � ( 'i �-� I <br /> Proposed Use of Bwldrg � Contact Person (Plan Review) <br /> I ' i <br /> Description of Work lo Be Done: ; ��-i' ` -I����� I i�l-�'�/ �:i i' i I-�. - <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�I!IRED TO FEE <br /> BE IN P 1C�=WAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRify that I have read and examined fhis applicalion and know the same to be tiue and <br /> conecL All provimons o/laws and ordinances govemmg lhis type o(work will be completed <br /> whether specdied herein or noL The granling of a permit does not presume to give authority to <br /> vio/ate or canc2�the provisions o)any ofher state or local law regulating construction or the <br /> wo�k lor wh ch appl cali rn��madet and 1 cotmply with the Sfate Confra/ctorsPL2v�ld 27�RCW and <br /> 296.200 WAE. . <br /> i ' j� ,j, <br /> �-�j.I�-'"..c•'�: � , <br /> G - .L� � �l�.j (�<_i. <br /> �'� ignaWre Date <br /> � �.-�J��J "U75 <br />