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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 /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDR CARDS ARE NOT ACCEPTED <br /> �/,5�3s Gal6r, �v> <br /> PROJECT ADDRESS <br /> Nu��-rt /lt,�� ;Gu i9- n�c�cr2sR,J /8yl/ 4cl t'' �'�ris �.cJ C�„o� cu� <br /> Owner Mail AdCmss Ci:y • State2ip Phone <br /> H'1Uftif �kc�1J <br /> Tenant Mail Address City StetelZip Phone <br /> _ G2L ��Ejz �S�-Z 2uc�c� 4tiP F�.ac�J� v-K �i��o/ <br /> Electrical Contractor Mail Address City � State/Zlp Phone <br /> C-��;�o'� ak �i��1� G <br /> State License Number � ConVact Price a(Work <br /> �OSzdtt�+i Z1¢ ( �� � <br /> Proposed Use of Building Contact Person (Plan Raview) <br /> Description ot Work to Be Done: /�G��,�lk.�C �L77L U(�C�v ,�(/(� ��'►Lf1J <br /> ��1� � �M�� �'�i . � f�frL <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 that/have read and examined this application and know the same to be true and <br /> correct. All provisions ollaws and ordinances goveming thrs type ol work will be completed <br /> whether specified herein or noL rhe granting ol a permd does not presume fo give authonty to <br /> vlo/ate or cancel the provisions ol any other state or/ocal/aw reguleting construction or the <br /> perlormance oI construction. That I am authonzed by the owner o(th�s property to peAorm the <br /> work lor which application is made and I comply with the Sfate Cont�actors Law 98.27 RCW and <br /> 296.200 WAC. <br /> �S��w��� � ��!_ ��/z G � 1 <br /> SignaNre Date „r( <br /> � ��,. <br /> �_ �� � <br />