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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, 1NA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FR(iY�8 AM TO 4 PM <br /> .�i���� Y,q�IK�"i� GJtHf"F'�� G��L �7��� <br /> PROJECT ADDRESS <br /> T�,� � f�r�,.s�•j� t��,I�,r Zy307 .����� (.�� �T�/1y z�r f��_���.yy <br /> Owner � MailAddress City State2ip Phone <br /> �i.�-r�✓'� P2a,'���':u7'S 3l/4 JSn^o���tlo� �G�nt� Lcf�t- �}�-'3 x[b' 71.�S'�S�/ <br /> Tenant Mail AAd�ess City Slate2ip Phone <br /> '3'�',533l�Jf2 <br /> Ci ����vx-r S{i SvrtJ.�e 5.70�f• /ZZ "`f�i+ke�E � � ri'.�� <br /> EledncalContrador MailACdress City Slate2ip Phone <br /> CuGf�5s9g�MU �„��zn�o ��o�'�' -•— <br /> State License Number Contrad Price of ork <br /> �]M/�9HC�)/ �r.csn.h'S <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description ot Work to Be Done: i ns'�h l� No�.l �fc77[�lNPh7 S%� �6r ��Vt�C��`��T�' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 �'��V� �'� c! <br /> c.i-� <br /> I here6y certify thaf 1 have�&ad and examined Ihis applicafion and know fhe same to be true and <br /> correcL Atl provisions ollaws and ordinances goveming(his fype ol�vork will be completed <br /> whefher spea/ied herein or noL The granfin3 0/a permd does not presume fo give aufhonty fo <br /> violate or cancel fhe provisions olany other sfale or local law regulating consfruction or the <br /> peAormance o/construction. Thaf I am au(ho.ized by tho owner o/this property fo perform fhe <br /> work lor which applicalion is made and I com;-�'y svith fhe Stafe Contractors Law 1827 RCW and <br /> 296.200 WAC. <br /> � /�v '///�i!'� � ���3�n.-,<s� <br /> Sig� re Date <br /> � <br />� <br />