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Sep IS 04 12: 25p P' 1 <br /> i <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982C1 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM -DEBR &CREDIT CARDS ARE NOT ACCEPTED <br /> � �"o� � d/�-I��YL �.I(l� <br /> PROJECT ADORESS yl"S <br /> �.>'� <br /> � f�V �'P11a I lY?- r <br /> Il'�A-F'-1/� iTE F�Fr Yl�� 1 � 2�-. �'�'`R svurziv Phona <br /> Owner Mail Addrcsa . Ciy <br /> Mail ACEress City SUte/Zlp Pnone <br /> Tenant �3f <br /> � �.,�,AF�h SxS 3Ga� Fct/��[K�/' .�v �v QP� z5P'�/4� <br /> Electrir.al COntradOr Mail Address <br /> Gy SntarLlG Phona <br /> ������f Z � '— Contract Price of Work <br /> Slate License Number <br /> pmpoe d Us`e f Buildirg Conta�t Parsan (Plan Review) <br /> DescnpponofWorktoBeDono: ,/L�11.�6.1 �.11���-- ���v�r ���� ������ — <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACE`NAYS, MC OR AC CABLE. �S--d Q <br /> � <br /> CITY OF EVERETT LOC.1L SALES TAX CODE IS 3105 <br /> 1 hereby certily that!have read and exammed this appllcafron and kncw fhe same fo De true and <br /> conect. AI!provlsicns o/laws and ordinances govemmq this type el�.vo�K wrll be complefed <br /> whether speci�ed herem or ncL The granfing o(a permd aoes net presume fo give aufhorrty fo <br /> vio�ate or cancel the proviswns ot eny o(her sta(e or local law regulating c�nshuclion or the <br /> IpeAormance ol constructicn. 7hat 1 am auiho�zed ny tne ownar ol1Ns property to pedorm fhe ; <br /> wo�k!or which application is made end�comply wdh the State Contractors Law iH.<7 RCW and I <br /> I296200 WA . , <br /> i �. ��' �'/S <br /> iqnaN�e Date <br /> � <br /> �_ `� Ci � <br /> � � <br /> �- -- <br />