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i <br /> ELECTRICAL PEF�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CGDAR 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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> >j G � ���-c,���-� w�r ✓ - <br /> PROJECT ADDRESS <br /> Owne� Mall Address City State/Zip Phone <br /> ��<cis�o „� �tih�f;on� s�(�5 c-��-G�C��til(�lAi ��� �/N- f���J <br /> Tenant Mail Address City State/Zip Phone <br /> �!/ ' S��rl ��'� /�'S'�8"�(c�� �'�' ti�,</n/uJd v� C✓�r SFc�.3G ��L�� �7Z -S���f! <br /> ElecMcal ContraCtor Mail Address Clty State/Zip Phone <br /> �Jc�l %`" SS a�`f.l� 1� � �'�� ��o � �� <br /> State License Number Contract Price of Work <br /> Ac,�-v �l1., D s' /�7°A�/� �o.V �i4 �.�c o ,�.D <br /> Proposed Use of euilding Conlact Person (Plan Review) <br /> Description of Woric to Be Done: �C�.+t� V U� �/I�c'� �/ /2� ff'�v��C/lJ �'J u��G�� <br /> /3.,����'�"d <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWA`(S. MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that 1 have read and examine�Y this application and know the same to Ge true and <br /> correct. All provisions o/laws and ordinancrs governmg this type of work will be completed <br /> whether speci(ed herein or not. The granttng of a permit does not presume to give aufhority to <br /> violate or cancel fhe provisions any other state or local law regu/ating construction or the <br /> peAorm3nce of construchon. ha 1 am authorized by the owner of this properiy to peAorm the <br /> work for which application is ad a comply with the State Contractors Law 18.27 RCW and <br /> 296.20 WAC. <br /> ��-�' y,�/ � <br /> Signature Date <br /> �oW�9-�� <br />