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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES U.�q ,a s <br /> 3200 CEDAR STREET, EVERETT, WA 98201 L��O U�� I <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 'ri � �� � �, V h�� �� c �,�t;,.ti� 1�� <br /> PROJECT ADDRESS <br /> `�brr��,� � �Zvo � D �A��ru � � 82N �u� �.� r�ve L�r.ti� fi} 1�'A �i�31.01 <br /> � <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mail Address City SWIe2ip Phone <br /> S�. (-� <br /> ElectnCal Conlractor Mail Address City SWte/Zip Phone <br /> Slalo License Number Contract Price oi Work <br /> Proposed Use oi Building Cuntact Person (Plan Review) <br /> Description of Work lo De Done: .7 � � � I'lO� ��A� �l��h 1�(� 111 �Id(7LT�0 � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAf3LE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />' I here6y coriily fhaf I have read and exaroined fbis applicafion and kno�v Ihe same to be(rue and <br /> corrnct All provisions ollaws and ordinances govemmg fhis fype oI work will be complefed <br /> whether specilmd herein or not The granting o/a permrt does nof presume to give authordy to <br /> violate or cancel fhe Provisiuns ol any other sfate or local law regulating consfruction orlhe <br /> pedormance o!conslrucfion. That I am authorized by the owner ol this propeRy to peAorm fhe <br /> work lor which applicalion is made and I comply with the Sfatr, Conhacrors Law 18.D RCW and <br /> 29fi200 WAC. <br /> �����1bL L'TO�tl.rnt �t2 .71�t-6' �{ -1`i - 0 `� <br /> tii9nature Dale <br /> �� �. <br />