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r ' — <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � a _ ,-�_ o�( <br /> 3200 CEDAR STREET, EVERETT, WA 98201 D �2 ��G� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org G y <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> .� � �� �Q ol6r <br /> FROJECT ADDRESS <br /> Tr��.�! 'I cbt FuY�s �{„A <br /> Owner Mail Address City Slale/ZiF Phone <br /> Tenanl Mail Address Cily Stale/Zip Phone <br /> EM��„�� �1<<� 1h� �yai Ns�� N.L. rLT,,;�i� w�, 98a�o yas��7•iqos <br /> Electrical Contraclor Ma�i Add�ess City State�Zip Phone <br /> � �� <br /> F/7 A 1 g?/ L S ������ <br /> State License Number Contract Price of Work <br /> u/,lrenoKJ � <br /> Proposed Use of Building Contact Per,nn (Plan Review) <br /> DescriplionofWorktu �eDone: �(JJDIrr�+ .�c_rvie�7�e ��e�QltrA�� Rui�� Nq��—��i � <br /> �. � L --���-�I L�n/ a /Q«,wl»r/ -� ... <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. � <br /> j` , <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby certily that I have read and examined fhrs apphca6on and know:he sarne to be Uue ano <br /> correcf. AI!provrsrons ol laws and ord�nances govemmg this type ol work �vill be complefe� <br /> whether specdieA he�ein o�noL rhe �ranhng ol a pe�mrt do�s not resume fo grve aufhonty to <br /> violate cr cancel!he prowsions ol ary ofher state cr local law reguPting construction or the <br /> peAormance o/ccnstruchon That I am authonzeo hv the owner ol this property to peAorm the <br /> Iwcrk/or whrch app��cafion�s made and I comply yvrtYi the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> o��.�0 �.,,�.��' ,� ;a—/7-oy t � `//%-o �% <br /> S�qnawre �a1e <br />