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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CED.AR 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&CREDIT CARDS ARE NOT ACCEPTED <br /> 'v�ii)La�Pi��;_:�.rr\ I�Iv�� / �\;: i ���t�� <br /> PROJECTADDRESS � <br /> .1��,�k-rY ���a�i����;�.�e7 (r-�c�� C � l;v:,vit ���il ��IS?[,-, � <br /> tl�nnu�iYl /4Zsl :'l�S -(,,;1� <br /> Owner � Mail Address Ciry Stato/Zip � Phono <br /> �\ � � \� l� / i <br /> Tenanl MailAddross City State2ip Phone <br /> '1ful��rC-� ���iAC��.�� , Z22_1 C0.�iZt•rii�C� �Ui� 1 t� �l�N `-)7ZL�l ���5 Z'��'-���.5* <br /> Electrical Contraclor Mail Atldress Ciry Slate2ip Phone <br /> �C>I� 1Tl'-k?__1', I�IN ��•��3l `, ���� <br /> , <br /> Slate License Number Contracl Price of Work <br /> i` � � <br /> ;A��� �. . � \,'�,-�li,�i`IY �;�l�t'�l�C.lr 1'� — <br /> Proposed Use of Building Conlact P�rson (Plan Review) <br /> Descrl tion of Wark to Be I7one: �Vl S�t't 1 �ry'�i C i 1 �-� � � �-(Lta l-_ ��C'[ �i.� ,Tu <br /> p C ��- Ui' <br /> i <br /> `��\`��l�1'� � - <br /> � - — <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEINAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> corererety A/l p�rYovhsions cf laws and ordinan�ces governPng fh's type o%woW k 1 vi116e completede and �V 5V� -U�11 <br /> whether speafied herein or noL The granfing ol a permrt does nof presume ro give authonty to <br /> vio/ate or cancel the prcvisions o/any other sfate or focal law regu/afing consfruction or fhe <br /> peAormance ol conshu�;tion. Thaf 1 am au:honzed by the owner o/th�s propeRy to perlortn fhe <br /> work lor which applicatian is made and I cumply with fhe S1ate Cont2ctors Law 18.27 RCW and <br /> 296.20 WAC. <br /> � <br /> � ,� . <br /> i' i.0 !l l'� i ���11('Y� l.''�-v � o � \ 1 c �'. - <br /> ,� Signatura - ato <br />