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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 /> ,� �P� .5 �(,`p c�. i1 C.o 7 Q � / <br /> PROJECT ADDRESS T <br /> Owner Mail Address 'Cif��� Slate2ip Phone <br /> ���r�'1c�c k s �o �fc�e . c v � 31 <br /> Tenant Maii Address City State/Zip Phone <br /> tYlOo�'1 ��.� t��e��t [� /7Y0 �1 S�rvu�n �k S��JCvt�l15�� I�JG 48d�1� �/aC�al3��G� <br /> Electrical Conlractor Mail Address City Sfate/ZJp Phone <br /> ��n oe r� Ec � R4�i m C' //� S`^Do <br /> State License Number ConVact Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Workto Ba Done: �Q� � �NO,reudmmY- �i � S— OuJl.c�• s /� ►�.s..,� <br /> �' <br /> /to Lour C9n�,�..� . !J �i4[- G,l' �stnu��� <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 COOE IS 3105 <br /> I here6y certily that 1 hava read and examined this applicatlon and know the same to be frue and <br /> correct. All provisions o/laws and ordinances govern�ng this type of work will be completed <br /> whether specified herein or not The g�anting o/a permd does not presume to give authonty to <br /> violate or cancel the provisions of any other state or local/aw regulating constructron or the <br /> peAormance of construchon. rhat 1 am authonzed by(he owner of this property to pedorm the <br /> work(or which application is made and I comply with the Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> y i b-�� <br /> Signawre Date / � <br /> � <br />