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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8d'0 - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T & CREDIT CARDS ARE NOT ACCEPTED <br /> ��'DG 44,�a� ` t _ <br /> PROJECT ADDRESS <br /> �".(J. V-�u:��� r�'�� i�1��. � '1(I C-��-,-cf� vVl� �f�'z06 <br /> Ownef ' Mail Address City Stale''<ip Phone <br /> Tanant Mall Address Clty StateiZip P�one <br /> Electrical Contraclor Mail Address City SlaleiZip Phone <br /> State License Number Contract Price of Work <br /> �u rct9� <br /> Froposed Usr, �wlding Conlacl Person (Plan Review) <br /> l r <br /> Description ot Wark to oe Done: rJ"e✓V�L L rU � Q V.' LU I Y�I ✓1� 0 1 ��/L� , <br /> J <br /> NOTE: VVIRING IN NON-DWELLINGS IS RE4UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> i herehy r.ert�ly fhat I ha��e read and exammed this aop�i,-;m:;n vnd kncw the same to be true and <br /> co.recL All provisions o/�aws antl aainances goveming this type ol werH will be complefetl �- <br /> whether specdied herein or nct lhe grantmg ol a permd dces net presume to give aufhonty to l <-��CJ 7 � ��Y�� � <br /> violate or cancel the provisions nl an}�other sta�e or local�aw regulatmg censlrucBon or fhe <br /> ' peAormance ol construction. 7'hat 1 am authenzed by the owner ol this property fo peAorm the <br /> ��vork lor�,vn�ch app6cation is made and I campty wdh fhe Sfate Contracters Law "8:7 RCW and <br /> 296.200 WAC. �- <br /> / <br /> ��j �+ .� <br /> ,��1�' /7•l�5 <br /> � S���nai.r,e Dare <br /> L—_—_—..__ -- <br />