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ELECTRICAL PERMIT APPLICATION <br /> CITY �F EVERETT PERMIT SERVICES s -a q�o8 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 L ��5`�5S <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROhA 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � �1(> � � ��� C.��,. .,,,, �1�� `1S �' �`1 <br /> PROJECT ADDRESS <br /> ��), i t' , n .� <br /> Owner Mail Address Ciry SlateiZip Phone <br /> Tenanl Mail Address Clty Slale2ip Phone <br /> '� e M 1 �<��2 1 U 6;'n7`1�� M'1nt�v ���, �'.� `�NL.l7 �{�°) ��tc�s�-� <br /> Electrical CoM�aclor Mail Address Cily StalelZip Phone <br /> �{N1L�tl* U7 -ll< (L �� 13 � - <br /> State License Number Conlract rice o(Work <br /> L : �w 1�6�( I�_� — <br /> Proposed Use of BuilAing Con�act Person (Plan Review) <br /> I � <br /> I � �{,}y I I .tJ�'w �C�.a.�I Ti�..�.y •-,,,.,_c,.�` a...� ��,� /r/� <br /> Dr,scnplion ol Work to B�' L'nnu /' <br /> ¢i n�r��-- c'.�(�-, j' �—c—� i ,�, ,'��_�; S C.�/� N S—Z/�1 <br /> � <br /> NOTE. V�'IRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. -� ^-� � !^ <br /> � , <br /> i CITY OF EVE!2ETT LOCAL SALES TAY.COUE IS �105 <br /> � ' r�,�reby ce�ti'y thal l have refld and exammed fnis applicefion and tinow the same to be frue and <br /> � :nr.cL All p;owsions o(laws end�vdmences govemmg fha fype a�work wdl be completed <br /> :;nether speu6ed herem or not rhe granting o!e pernuf does not prnsume fo give aufhonty fo <br /> ,-iolate ur cancel the p�ovisions ol any other sfate or local law reg�/e6ng consVuclion or Ihe <br /> � i�erformance ol conslructicn. Thal I am eulhonzed by Ihe owner o�this property fo peAorm the <br /> � ��vr,rk lor which apphcahon�s made and I comply wifh the Stale Confractors Lew 1H.?7 RCW end <br /> � ,-Ur zop�i�c -' <br /> 1 � � � <br /> � ; ,�. <br /> S � ` <br /> � � <<._ � ��< < �_ <'f � t ,, <br /> —__b�;i,-ai�ru � D te — ' . , <br /> �_—_—_— —_— — __ — <br />