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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 425-257-9857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> l. l+MLS �� G� �� � � ��UhV-:. _i�1 S� � <br /> 3 � �- � a �o�� ��� r4`� <br /> K' �r2E-i% W e� <br /> PROJECT ADDRESS <br /> (�- 1"�M u T p Gi.JE�c�ri t_n� T ZOG <br /> . . _ . . 377_� �o►'�Dk'11`r �v�P�<< 1,���RS2ar �t5-i05G <br /> Owner ldail Address City State2ip Phone <br /> ZCJ(: <br /> ,lnHEs M M�Crca., 32J�G; �����q� ���.-�rr �.�� � i s- r � >6 <br /> Tenant Mail Address City State/Zip Phone <br /> 3�- c, <br /> G ' _�►-T/N� lNC. >oo E. MIIIl�15 � MoN20E GJi9 r1l��72- 79N- 7j�� <br /> Electrical Contraclor Mail Address City State2ip Phone <br /> �r5 NE��-.= b�5 G� � S, 5 �> � <br /> State License Number Contract Price of Work <br /> �ey c �oc. ro � a�v }l�y� r�eY <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description af Work to Be Done: ��� y t �t � � �_ / � rS � � l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACGWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby ceRi/y that 1 have read and examined this apA��cation and know the same to be true and <br /> correct. All provisions o/laws and nrdinances goveming this type of work�vill be completed <br /> whether speci(ed herein cr not The granting of a permd does not presume to qive authonry to <br /> violate or cancel the provisions olany other state er local law regulating construction or the <br /> performance of construchon. That I am authonzed by the owner of fhis propeRy to perform the <br /> work for which application is made and 1 comply with the State Contraclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ' /��� ,��c,..�-s.�o�-�, / /— /o — � E <br /> .T Signature Date <br /> �L(� �I-C73 <br />