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l —� <br /> ELECTRICAL PERM�T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.nrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8� CREDIT CARDS ARE NOT ACCEPTED <br /> SS 3� cua.��( <br /> PRO.IECT ADDRESS <br /> L -cr t..�.•�c.- r � ZL /4{d' a� PL G tio. C+�'� <br /> Owner Mail Address Ciry State/Zip Phone <br /> Or��N MO�{ c'S CO�I/$ION SS.3C GVLfyYCe�l Lv�Y ZV"� <br /> Tenant Mail Address City StatelZip Phone <br /> ��. <br /> �ur Gu�� ev 7�/�0 //4..��scw R� �ve.�/.k 4vF SFfzo� 77�`S�(�(SS' <br /> Eiectrical ontractor Mail Address City State/Zip Phone <br /> /��:�rdNr � SSSL '3 � �`S'p� �o <br /> State Licen e Number Conlract Price of Work <br /> CGFr 'c_ . 'r ��'fc�a Lo� <br /> Proposed Use of Buil ing Contact Person (Plan eview) <br /> Description of Work to Be Done: i 1,��L! �l � �� � !� S�Tn/ � ��� ���'« S�� ' <br />` <br /> NOTE: VVIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and axamined this application and know the same fo be true and f��O('�-�j�� <br /> correcL All provisions of/aws and ordinances govermng this type o(work will be completed G <br /> whether specified herein or noL rhe granting o(a permrf does not presume to give authority to <br /> violate orcancel the provisions o(any otherstate orlocalla�vregu/ating construchon orthe <br /> peAormance of construct�on. That I am authorized by the owner o/th�s property to perform the <br /> work(or vihich application is made and 1 comply with fhe Staie Contractors Law 18.27 RCW and <br /> 296.200 INAC. <br /> //�' ( ���� U � � <br /> �S nalure �ate ( I <br /> 1 '� <br />