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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> P.PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> > I , <br /> � � - -X� � • i:f : ��. � , �..' [',a�, �v <br /> PROJECT ADDRESS <br /> �� <br /> ~�' �' � � <br /> OWner Mail Address City Slale/Zip Phone <br /> 1 <br /> � � <br /> Tenanl ��.4 Mail Adtlress City Slale2ip Phone � <br /> �t��r� f=��J � Pi���� )��`f i�� �.�, � Ir< <���Is-s � 7� ,; � �;: ��,�; <br /> Electrical Conireclor Ma�l Address City Slale/Zip Phone <br /> �_ � i <br /> � ' �� �� � i .�� ' 1 , - ') � � �; � � �`�/U <br /> State License Number Conlract Price ol Work <br /> f �,��-�-�'r�i'. <br /> Proposed Use nl�uilAing Contact Person (Plan Roview) <br /> \�' i <br /> Description of Work to Be Done: �°^' � � `` � ,+' �� � ifJCk� �✓ �"� � ��-��f��'� , __ <br /> �q a � ,� < � +- l� f1 U � n� �� - I. - ��?�����•i — <br /> NOTE: V.'IR�NG IN NCN•DWELLiNGS IS REOUIRED TO fEE <br /> BE IN RACEW.4YS, MC OR AC CABLc. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 hr�rehy reRn��fhnt I have�ead ar�d exarn�ned fhic npplicahon and know tho same fo be true and <br /> conecf. All prowsion;o/lavs and ora'mances govern�ng thrs fype ol woik wdl be complated <br /> whether sp•^cihed herem or not i he yran6n9 0!a pernuf does nof resume fo give authonty fo <br /> violafe or cancel Ih,e provisions c/onv other stafe or lor.al law reguPhng r.onsbucGon or fhe <br /> performance ol censVucbcn. Tiiat 1 am authonzeA by the owner ol fhis p�operty fo peAorm fhe � <br /> work lor which applicalion is made and 1 cornply wdh fhe Sfate Cunfractors Law 1A.2i RCW and / /, <br /> 296 200 WAC. ;� <br /> � �� , � ��� , � �� � 1 <br /> ___L awn, Uate <br />