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ELECTRICAL PERMIT A�PLICATION <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 />�'; - ( � / Z l3 �� l �< � �-� � �l<< � �1� � <br />PROJECTADDRESS <br />/ � <br />��r,����'.r��'c,�� i'l��i. >� � <br />Owner Mail Hdaress <br />S'� � r�, E, <br />City <br />Stale/Zip <br />Phone <br />Tenant Mail Address City Stato/Zlp Fhona <br />���c,�c C��c��•�r<< ll���' �,����,�1�� �1��� �fCc/��A7 <<„E�-�� lc�� �iiS <br />EleclricalCoNreclor MailAddress Gry 1 � Stale/Zip Phone.. <br />h C � /ZC,�,(� �_ :�53 6I� <br />�' �� � ti�� �_ %�>'' �"� � l � 1 / -� �G���' <br />Sta�e Licenso Number Contrar,( prico of Work <br />�'C'��iQ'�(- il ���r��� �16t'�.:�� i ,r� <br />Proposed Use of Building Contact Person (Plan Review) <br />Descriplion of Work tu Be Done: L/f,C'l �/ i�i � l �'; //�� �� �� �'Ltf f(�' i f���EIiZQ Cri� <br />i <br />i ��i j-i il�� <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN R,4CEWAYS, �v1C OR AC CABLE. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hemby certi(y that I have read and exammed th�s applicetion and know fhe �ame to be tiue and <br />correct All provisrons ollaws and or�mances goveming this type ol work will be completed <br />Khether specilied heie�n or noL 7he qranbng o/ a permrt does nol presume fo give euthonty to <br />violate or cancel Uie provis�ons ol eny ofhei sfate or local law regu/a(ing construcfion or the <br />perfonnance ol construcfion. Thaf I am authorizeAby fhe owner o/ this property to perlorm fhe <br />work lcr �vh�r.h applicafion is made and 1 compty with the Sfafe Contracfnrs Law 18.27 RCW and <br />296.200 WAC. <br />�? <br />a % C ��(' (�•, � %/� �`� !'S' <br />� <br />---- siy;c. h;m .^ --- Dai <br />�osos-o49 <br />F <br />