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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 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 />� <br />S l ��'i f')i i�r'i �� �U�J�C� �C(-'i' ?,';� �-Yt'�itl <br />PROJECT ADDRESS <br />� <br />��,� l �l l�lf =' !l! '� Zr; I <br />owner <br />Tenant <br />C��-����,% �i�t�� <br />Eleclrical CoNractor <br />Mail Address <br />�, � ��;�,, ��-; � y�� � c ��,��r <br />1"���. �.��;�-13��ti1�� A�E <br />Mail Address <br />(:'c. i�U1-t.r' 9�i i �?y <br />Slale License Number <br />/ <br />�,:/lli��r �-�un�l�; %�rl�rll��rl, <br />Propose Usc af E3uilding � - <br />Ci�y <br />Cily <br />(. U��� �� .arv �1��, �w �� -(� �� <br />Slatc2ip Phono <br />State/Zip <br />Phono <br />( Kvle�'e�� �� i.-(,� �t °7��,� �r �1 �5 �.��i� -�i�'G�l� <br />City Slate2ip Phone <br />�3 �1��t-. � �� <br />Contract rice of Work <br />/i <br />C(11rl�.� C'� ,.�c�l.'7 <br />� <br />Conlact Person (Plan Review) <br />Description o( Work to Be Donu: '��� l �� ��� -�� '. � f 1!� I ��- <br />l1 �1�� !'�'�>lc�r;����c: <br />NOTE: WIRING IN NON-UWELLINGS IS REQUIRED TO <br />BE IN RAC[WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cert�ly Ihaf I h�vr, iead and examined Ihis applicafion and know the same to be true and <br />coirect All piovisions ol la�vs ar�d ordinances gov�mmq this type ol work u�ill be cempleted <br />whefher spec�Gr.d herein or noL The c�ranting ol a pem�d does nof resume to �ive aulhority to <br />viulafe or cnncel tbe provisions al any ofher sfafe or focal law reguPtin� consVuc6on or Ihe <br />perforrnance ol consf�ucfion. That I am authoiized Gy fhe o�vner ol tlus property to peAorm (ho <br />work lor which applicafion is rnade and I cornply wifh fhe S(afe Contracfors Law 18.27 RCW and <br />29G.200 WAC. <br />�1 �, <br />.l %.F--4r',A���j �l: LfL(Cc. �l <br />�!�� �i �L% ` � <br />FEE <br />