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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 - GE81T 8 CREDIT CAROS ARE NOT ACCEPTED <br /> , <br /> a �� .<7 . � �c<� . <br /> J ,�J�� i- — <br /> PROJECT ADDRESS � <br /> ,-, , J ��� y e N >7 1�f� `�J���� �'S�� - ���, � <br /> I�, �� �. OcC" a c�rt' " G - � . , /'C".'i � <br /> Ownef Mail Address Ciry State/Zip Phone <br /> �1,: s�r _s��, e <br /> Tenant Mail Address Ciry Stale2ip Phone <br /> t, <br /> !'' � :iS ¢�' � �"1r �,+ � I <br /> Electrical Contrector Mail Address Ciry StateZp Phone <br /> ,/ ✓'_�L j ./-1-1� ? 7.��t �S U <br /> State License Number Contract Price of Work <br /> fi��_ � <br /> Proposed Use of Building Contact P��ao,. (Plan Roview) <br /> � <br /> Description of Work to Be Done: �'-j•� � 1' � J /',�. z n-�- ' C'c�-" - �"�' l'' '' � <br /> � <br /> -> _ <br /> ��� � / �� C � ��' .� CJ ��1.-�,., ���C. i t <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R/,CEWAYS, MC OR AC CABLE. -s `" <br /> �S <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i <br /> 1 hereby ceRify that 1 have read and examined this application and know 1he sam=to be true and i <br /> cor�ect. All prcvisions o//aws and ordinances governmg;his tyoe o/wo�k will be completed <br /> whether soecilied herein or nct The y,-anting o/a permd doec not presume to give authcnty to <br /> vio/ate or cancel the provisions o/any other sfafe or local law regulating construction or ihe <br /> peAormaoce o'construchon. That I am authorized 6y the own�:r of ihis property fo peAorm the <br /> work�or H�hich application is maCa and I comp/y with the State Contractors Law v8.27 RCW and <br /> 296200 i'VAC. <br /> f r!�-'<i' �� C �� "JC� "t� <br /> .Slynat:re Date <br /> Eosi a-�r� <br /> I <br />