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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 />i <br />�lly /�<'v�'�"ly L.o.�¢� <br />PROJECT ADDRESS <br />�i <br />�,�v�-; ��� _�,,,e �-LC'. _ <br />Ownr.r I.1�d Address <br />Tenan� <br />Electricat Contractor <br />Slale License Numt�er <br />Proposed Us�t a( E3uilding <br />A1ail qC:Jress <br />Afail Address <br />City <br />City <br />City <br />Stale2ip <br />Slale/Zia <br />Slalc/Zip <br />Phene <br />Phone <br />Phone <br />�i5 D�'vU <br />Contracl Price ot Work c� L 1� <br />[3; �/ LonGu F— ��93 -�3'S <br />Conlar,t Person (�an Re�.iew) <br />Di�scnphun n� uVurL t� Hc Donc L. 1�1.�� ��G i c'.G �_S `( I.' v lC G "' l'.iJ /�'_ `L- /V� �v �� 9,<' �iC• �. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACE'J�1AYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 3105 <br />I h�=rohy cer6ly Ilmt I huve reod ��nd exarnined this applicafion and knew:he same fo be tnie and <br />conorlt All piovisrons n7laws and ordinances 9ovemmg fhis fype ol woik �vdl be completed <br />n�he(hcr specilied hmom or nof The pranfing oI a pennd Aoes not resume fo 9ive autho�ity to <br />riola(e or cancel Ihe provisions ol any other state or local law reguPting consfructio;� oi fhti <br />peAornrance o/ conshucfion. That I am authorized by fhe owner ol this property to peAonn fho <br />�vork lor whicb applicafion is rnnde and 1 cornpty with fhe Sfa(e Contractors Law 18.27 RCW and <br />zs� zo� wP���., I �a �, � � �. <br />�,� , �� , ,z _ _ 9/��iJ� <br />�FEE <br />,_ � <br />. � � _ ,, <br />