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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAY. �25-257-8857 -wv,nv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ' �l % �'�l/y r��� _ <br /> PROJECT ADDRESS <br /> 5k�1/ G�� �5/d�u� � <br /> Jwner Mail Address City Siate2ip Phone <br /> Tenant Mail Atltlress Ciry Slate2ip Phone <br /> (�q�kpl'S E�c°c]'�iic .1Nc. 583� 4l.�rer- (�. G�aKt4c Fcl(s, lrt��-_ 9�"lz�Z .�-69/-67� <br /> Elecirical Contractor Mail ACdress City Slale/Zip Phone <br /> W�ILkL'C.I96vJ2 � � ��—�J �v 7� n�_� <br /> State License Number Conlract Price of Work <br /> J- � 7�CS . <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> Description of VJ�rk to 8e Done: ��`� J G(.�°Q-7'�r5 i✓l ,Lj�p��'ao�vl5 <br /> NOTE: VJIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have reaA and examined this application and know ihe same to be true and <br /> correcL Afl provisions ol/aws and ordinances governmg this type ol work wdl be comple�ed <br /> whether speci6ed herein or not. The granfing ol a permd does not presume to give authority fo <br />, violafe or cancel the provisions ol any other stafe or local law regulaling construction or fhe <br /> peAormance ol constructron. That I am authonzed by fhe owner o/fhis propeMy!o pedorm the <br /> work lor hich applicafion is made and I comp/y wifh the State Contractors Law 78.27 RCW and <br /> 296.200 AC. _ <br /> �" / � 'U 7 <br /> SignaNre Date <br /> e�� <br /> Ea�C7-c3� <br />