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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER�ICES <br /> 3200 CEDAR 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 <br /> � . -3 i�� 1�, e� �u<< e p . I <br /> PROJECT ADDRESS <br /> �.� �a !-� � �E Z �1�C /�i T�>.1�t/�(l� %S'�e�� /,1-a� `�`s:>>2� <br /> pyypg� Mail Address City . State/Zip Phone <br /> 7/�<:o ��1d yv�i"� _ <br /> Tenant Mail Address City Shate/Zip Phone <br /> � N- �' ��FE 2��� S� is�HrE-� u�� � c� %1'� /� G����� c�� I�i�3� <br /> EleCtriCal ContraCtor Mail Address Gb State/Z�P Phone <br /> � �., <br /> J � � (� x �c �vZ t�L�t � GSvd . <br /> State License iJumber Conhact Price of Work <br /> `f,%: �r �v[�S�_ � /�Z�'UJ >L• 61�4! `� <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Zv[:— 4 73- ���,'� <br /> Descriplion of Work to Be Done: /-�'/� z�'���a`�'�' `���� v" � j� �w��`"p <br /> �/-�-fL.i / <br /> NOTE: W IRING IN NON-DW ELLI'IGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 he�e6y certi/y that 1 have read and examined ihis appfication and know the same to be true and <br /> correct. All provisio:�s o/laws and ordinances goveming fhis type ol work will be completed <br /> whether specil�ed herein or not The granting o(a permrt does not presume to give authonty to <br /> violate or cancel the provisions ol any other state or local ie���-regulating conshuction or the <br /> perlormance olconstruction. That I am authonzed by the owner o/this property to pedorm fhe <br /> work for which application is made and 1 comply with tLz State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. '' ,• / <br /> � <br /> � � :%�% � �- /�'-!i �� � 3 - d�� <br /> �ignature Date � <br />