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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> J� u� c.vl bu (1�.� s� �+� �o� <br /> PROJECT ADDRESS <br /> Owner MailAdtlress City Stale/Zip phane <br /> Yi� i3r.unk/5Gi lioi 1�c.�.�fc. Aue, ,io.covn�� �� 9�402 z533c�5z� / <br /> Ten.� MailAOdrecs Ciry Sia�arzip pnone <br /> r:�clu�o.,5�-{ctt�l '0"231 15� Aue.'.i SPu2��{?� (,�L_ qf')�:i`l �(X.� 6Fi[ fiJ � <br /> ElectncalContractor MaiiPddress _ �Qlty SlatelZip Phone <br /> f:� -.� <br /> %�/dc�_si �rSP,G �l3CYJ.UO <br /> State Licensa Number Contract Pnce of Work <br /> 1'i-�r. ;;��, i�Ci�r,� /�;�'��f i1���� Gc�c-��.� <br /> Proposed Use of Bui ing " Conlacl Person (Plan Review� <br /> Descnption of Work to Be Done: //'J j',�;.// (.i- ,�,�ii I l fU SlI,L�C?%�� ��(�/C; (� <br /> ��<(_��_ �G. `.��l9� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cedAy fhaf I have iead and examumd this applicafion and know tho samo fo be frue ard <br /> correct. All pravisons of laws m�d ordmances govermng fhrs type ol�rork will bo completed <br /> whe(her specified herem or noL The granhnq o!a pennrl doos nof piesume fo give aulhonty fo <br /> viola(e or cancel tho provisions ol any other sta(e or/ocal lau•regulafing consfnic6on or(he <br /> performance ol construc(ion. Tha�I am aulhonzed by the owner of this property fo perfortn the <br /> work/or which applicafion is made and 1 compty wifh the State Conhactors Law 7B 27 RCW and <br /> 296.200 WAC. <br /> ' %��'/,/�� <br /> �d/-i �� ��<�v�- �:� <br /> �� Date <br /> .�d �;o� . � /6 <br />