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i--- - -- <br /> ; <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � �125-257-?8 10 - FAX 425-257-8857 — www.everettwa.org <br /> � <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NrJT ACCEP7EU <br /> I ' 7G7 /.3���� <br /> PROJECT ADDRESS <br /> ,.1 GJ �A.Sr:,>�ut 3/�o G�(l,�`l��/�k� �vc- rc�� !cJ/� �'�-�Il�l <br /> Owner Mail Address Ciry SWIe/Zip Phone <br /> Tenant Mail Address Ciry State/Zip P�one <br /> SC� F_�.�r �r�� 3I�D��/��� P l� F��re�f ru�g 31� Gr�r _ <br /> ElectriCal :;onlractor !�tad Atltlress Cily StatelZip Phoae <br /> JC- ELE-�+� 367QN <br /> State License Numher � Contrad Pnce o(Wi :k <br /> � Froposed Use ot 6wldiny Contact Person (Pian Rerew) <br /> Descnption af Work to Be Done: <br /> I y C� <br /> I � <br /> I N�TE �ti'IRING IN NON-DWELLINGS !S REQUIRED TO FEE <br /> i EE IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETI' LOCAL SALES TAJ(COOE IS 3105 <br /> ' heie6y :eR�l:thdt 1!iei��ret;d and exem�ned lhis app6ca6on arld knOw the same to be true and <br /> . ;;rrecL All prcv�s�cns o1 faws and nrdinances gevemmg this type o!�.verk wdl be completed <br /> , .vnethei spealied here�r or nct The granting ol a permrt does notp resume to give authonty to <br /> .r,�iafe or cancel Lhe prowsions ol any ofber stafe or ior,al law regulaUng construchon or the <br /> nerrormance ol construction. That I am au�honzed by the owner o/fhis areperty to peAo�m the <br /> vcrk lo� wnich application is made antl I comply wdh the State Contracfors Law 78.27 RCW and <br /> 29fl200 WAC. <br /> .�'`j�,�,�,�,__lr / ��.�( 0 <br /> T ai5na Date <br /> / <br /> � � <br /> ! K ;�(-,; L� -l�, <br />