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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <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 -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> Io�I o-1 A;�w�� ��- s�� <br /> PROJECT ADDRES <br /> �1-�I-�-.� Pad�,`� ��� 6'3�v I 30'" PI � ���tr� G/1� QBo 2� <br /> �� Mail Address City Shatetip Phone <br /> Tenent Mail Atloress Cily State/IJp Phone <br /> geloa <br /> �Je��CP.h acEr� �. d� '727 S k�y� 5��� �/� `� Zo6 763-�9y�I <br /> Eiectripl Contractor Mail Address Cih State2ip Plane <br /> �vE-,C�� t?roo scs � Gcx� <br /> State License Number ConUact Price of Work <br /> ��CJL <br /> Proposed Use of Building Contad Person (Plan Review) <br /> I• ,�-- c / / � � � / <br /> Description of Work to Be Done: ��0�(nV� � �J��S `'�J� Vvl�oy� 1 <br /> d� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R.4CEWAYS, MC OR AC CABLE <br /> �ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certi/y that I have read and examined this application and know the same to be hve and <br /> conect. A/l provisions o/laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The g2nting of a permrt does not presume to give authoiity to <br /> violate or cancel fhe p�ovisions of any other state or local law regulating constructfon or the <br /> peAormance o/construction. 7hat/am au[honzed by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,n f <br /> ��ucL a��;�--- ���� 2�� <br /> Signamre �8 � <br /> �o�f l l - O at,� <br />