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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ,� � C� � Cu� /3 � � Vc <br /> Pf20JECT ADDRESS <br /> Owner Mail Address City S�ate/Zip Phone <br /> IC�E Y L�A NK <br /> T�nanl Mail Address Cily ;talo2ip Phona <br /> � l� I D��JJ C� ��L�C l0 `�' �y�7ti !�� Sti/ � NNwJD� yz.i <br /> y � w A �10� 7 ��g �oc�y <br /> EleClriCal COnUaclor Mail Address City Slale2ip Phone <br /> D�z � o����06 ��7 i�vv. �v <br /> State License Number Contract Prica of Work <br /> �JM �l <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of W ork to Ba Dane: C(�CL4� /�4/� l��(l�[ —///� �T��'1 (,�7 A ) fir"D <br /> C//'Gt9ifi {�'r� �/y�if��' SJrrUN�of' �vA � <br /> , � <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 /> 1 hereby certily Ihat 1 have m 3d and examined this npplicafion and kno�v fhe same to be frue and <br /> conecL All provisions o�laws and ordinances�overnmg this type o(wo�k�vill be completed <br /> whefhc:�specilicJ herein or noL The granfinr�ola pennd does not resume fo give authority fo <br /> violate or cancel the provisions of any olher state or local!aw mguPlinr�consVucGon or the <br /> pedomiance ol�q nstruction. That I am authorized by the avner o/Ihis property fo perlomi Ihe <br /> �rork lor whi�h application is made and I comply with fhe Sfate Contrac(ors Law 78.27 RCW and <br /> 296200 L1'AC <br /> / r� � �GGZ��', � �S'OL'��� <br /> i <br /> Si alure Date <br /> E05�i-0(Z <br />