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.� <br /> 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 AQE NOT ACCEPTED <br /> f"v� Fs.'�_T. G�-i7"u.�/1✓ GG.t.;F2 <br /> G,�n u- i.� !_'�/FLcF r'/F.v: T. / . <br /> :3 J .�--G ✓�8�o�e�t�i,'t `� <br /> PROJECT ADDRESS <br /> C.-l1Nr.�r; D6vEcrPiyr'a; <br /> Owner Mail Address City State2ip Phone <br /> C I}1MUi DE✓ELCPHFNi <br /> Tenant Mail Address Ciry State2ip Phone <br /> 3C o <br /> G�' S /�fi�ri�cJL S�� E195i }�Ni/U f'IJ�tI�EE l✓A 9P272 75��'730�, <br /> Electrical Conlractor Mail Address Ciry State2lp Phone <br /> G- S hI F- �L_,� D C� 5 C S / S f�a a �.�- <br /> State License Number Contract Price of Work <br /> �J r' �'(C- �-- ' l�cl!'v �"�IJY'�l�+/'�-�� <br /> Proposed Use of Building Contact Person (Plan Review) � <br /> Description of Work to Be Done: _ — <br /> — — .. e` Y v — __ -- _ _ . __ ' <br /> iN Si/f L L- � '¢'� �S %/j �S � z.U!(/G �'L1 NTi�2t LS <br /> NOTE: 1NIRING 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 <br /> I hereby cerify that!have read and examined fhis application and know the same to 6e true and <br /> correct. Afl prcvisions of/aws and ordinances governing this fype of work will be compieted <br /> whether speci6ed herein or not. The granting of a permd does not presume to give authority ro <br /> violate or cancel the provisions olany other state or local law regulating construction or the <br /> psrformance ol consiruction. That I am authonzed by ihe owner o/this property to perlorm the <br /> wcrk for which application is made and 1 comply wilh fhe State ContraGors Law 18.27 RCW and <br /> 296.200 WAC. <br /> '1 <br /> ��� / �� �, d � '� L <br /> n, - <br /> Signature Date ��7� <br />