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- o <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE-TT 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 <br /> �-� <br /> _�.� ��� ('f[S� �(]`,1�10 ���� �V�r{�r.ij i��F1 ���"J <br /> PROJECT ADDRESS <br /> ����-� 4� ,—sc 4�,.� fc -- — (. . .� �r �� „t�/i _�i� S <br /> Ownef I.t;iil Address Ci�y State�Zip Phonc <br /> Tenanl Mail Address City Stat�'Lp Phon� <br /> �. I < <br /> ,' � .�: r�c +r�• l.U- Sloj �t`t'' SiSIN tv.o��yi�a�cC .L2id4cR (,.1� 910`I� � ' " io >$" <br /> Electrical ConUaClor h4ail Address City Slate2ip ione <br /> , � ( � C �) <br /> � d Iq��'l ic� " ' ` - <br /> -[ Y1 V�4 <br /> Sla�e License Number Contract Price of JVork <br /> Proposi�d Use of Buildine7 Conlact Pcrson (Plan Review) <br /> DescriptionolWorktoBeDone: [e,ir.. �,,'O �'����� �'� .t41QIiL� :•'���'L y�', S'� FI �-k�:���•��'{ <br /> ,`�.li: ��— ��:..1 ��I.a.41_�� —�� n vr' � �' �-t� �T� /� I'�r' .�� <br /> '1���-- --�—r— t <br /> � <br /> INOIE ���IRING IN fJON-DW[LLINGS IS REQUIRED 10 FEE <br /> ICiE IN I�AC[WAYS, A1C OR AC CABLE. <br /> CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herrby ceiLl}�fh�it 1 h��ve read und exanmied fhis�pplication and know the same fo be fn�e and <br /> conrr.( Atl prowsions o!lau�s and ordinanceti�overnmr�thrs ;ype o!work will be completed <br /> whe@�e� spaa6ed hmem or not. The p�anGng o!a pennd docs nof presurne(o grve aufhority to <br /> violate or cancel the/irovisions ef any ofher sfafe ur locnl law rec�ulafing r,onstruc6on or th� <br /> peAomiance o(consf�uction. Thaf!am aulhorized by fhe owner ol this preperty fo perlonn the <br /> work lor which applicafion is made anA 1 comply wCh the Sfafe Con6actors Law 18..7 RCW�nd <br /> 296.200 WAC. � � <br /> C � - � � �`�_-�� 7��� � <br /> Sign.lure • — Dale <br /> ,- 1 � �' � � <br />