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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.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �{lvo3 ftLC1 � � AVEN �� <br /> �re�elt W Fk. �t�'; �� 3 <br /> PROJECT AD RESS <br /> y:zs s��3 isv � <br /> �'�trn��e�, 1�1 �-lct�r. 5 FGP�'-k �r¢-eff� lUA, `(��?�3 <br /> Owne� Mail Address Gty Slale2ip Phone <br /> �m , �z rf� s y��c� � /-�l��;- f,r� �Y'�rP� `lfj,�o� y�15 387 i y� <br /> Tenant Mail Address City SIa�e/Zip Phone <br /> Eleclrical Conlractor Mad Address City Slate/Zip Phone <br /> Stale License Number Contract Price ol Work <br /> `7i1'�c�l'E'_ �CCbK �1�-�' �L•l.�?�� ll�/\� �'��V'e. IICA'� r�S <br /> Proposed Us'e.�f Building � Conlacl Person (Plan Review) <br /> Cell ,�5 � �YI S/5 7 <br /> Description of Work to Bo Dono: {� . ILZ C� (�/C�1 ,�IJ1� //1 (�t{� �1Er•/�C�l S�r��1� <br /> � � / C� a <br /> � �'`�u_ (�1 �`�1 /�'�ti �7� �C��J �d/u-f �I�-ll�l / GtClC'l�j�Gr�a� <br /> /l� '� / I�C�C E:l�7l's s' �v� (',( �� �1��i l�'o� ��c� G�� 0.S , <br /> �7 V, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERF.TT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby certdy lhat I have read and examined ihis applicafion and know the same fo be frue and <br /> cormcf. All prows�ons ollaws anA ordm�nces yaverning fhis type o!work will be complefed <br /> whefhcr spec�hed herein or nof. 7he grantmg or a perrmf does not presurne to give authonty to <br /> violafe or canccl the provisions ol any ofher sfafe or local law�egulating constructwn or the <br /> per/nrrnanr,e ol construction. 7hat I arn aufhonzed by fhe owner ol this property fo peAorm fhe <br /> work lor which appdcation is ma0e and I cornply�vdh the Sfate Contractors Law iR.27 RCW and <br /> 296.200 WAC. ' i <br /> ��?7��� � /� L' � � ( ' � <br /> Si, aturc �ate 1 . � <br /> l,' <br />