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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 — �vw�v.everetivda.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> (K�sJ <br /> Kurc 7 i n-7 3f/Fl bv'acr�c�c��r �ve��y7 1.�� 95f2o3 �sz-Y7�r <br /> OwnC� Mail Atldmss � City Stale/Zip Phonc <br /> Tenanl ldailAtldress Cily State/Zip Phnn� <br /> �`!z SI <br /> COt�styy�;:t,� �r� �.� PO l.io 28'6 LQ,�r-�o� w� 9g25j' zq-4- zlz6 <br /> E-!er.irical Contraclor Mail Address Ciry Stale2ip � Phone <br /> �C.orrinryel9S�f c vY, <br /> Stale Licensr, Number Contraet Price oi Work <br /> Proposed Use of[3uilding Contacl Person (Plan Review) <br /> . <br /> Descriplion o(Work to Be Done: TC[JD �%ON � !1�C�(/ 7 <br /> / <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 G (_;�t O I -C�Z <br /> 1 hereby cerfily thaf 1 have read and examined fhis applicafion and knew ihe same to be true and �F <br /> correcL All provisions ol laws and ordinances govemmg this lype ol worR�rill be completed <br /> whether spealied herein or not 7'he gran6ng ol a pennd does not presume to give aufhonry to <br /> ciolate or cancel the provisions o(any ofher stafe or local law regulafing consWcGon or fhe <br /> peAormance ol consl�ucfion. Thaf 1 am aulhorized by the owner ol th�s property to perlorm the <br /> work/or which application is made and I compty with the Sfate Confractors Law 18.27 RCW and <br /> 296200 WAC. <br /> . �1-'Z3 — o <br /> Signature Ualc <br /> I—'---__________.... . .. . . . . . . _ . . . . _ .__ _---------��-- <br />