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� <br /> 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&CREDIT CARDS ARE NOT AC^.EPTED <br /> � 1 I V �1ILrC� rGt-N ��✓ 19t� <br /> PROJECT ADDRESS <br /> C '�F �ll� � 'EV /'.+c�LJA � ��I � / O v� O <br /> Own r (�v� „`�� I Mall Address Ciry State2ip Phone <br /> y_ 11 <br /> S�- A <br /> Tenant Mail Address City StatelLip Phone <br /> � ��c-c--�r� � G (� �i�,� erL� �co t�Jw z.2 <br /> Electrical Conlractor Mail Address Ciry Stale2iP Phone <br /> � ( l � �� o �93 9o2z. <br /> � 5�e.z--�c�- � �' 7� .��. `� l2/ ( G� ��a o 0 <br /> State License Number ' Contract Price of Work <br /> C�-2 //e�'-t /Q/-' _— �iEJ1 17 IL� f) r _ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Wark lo Be Done: � � r3.�. (' ,1/� �'��` �—S �� /V �4.� <br /> /,VT-e/�/�� �6��'t ( ��. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> ��� 7 � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y ceRi(y that 1 have read and examined this applicatior.and know fhe same to be true and <br /> correct. All provisions o/laws and ordinances governing this type of work wlll 6e completed <br /> whether specified herein or nol. The granting of a permd does not prasume tc give authonty to <br /> violate or cancel fhe provisions o1 any other state or local iaw regulating construction or the <br /> pedormance of co ruction. That I am authonzed by the owner o(this property to pedorm the <br /> work(or which I'�ation is made and 1 comply with the State Confrac(ors Law 18.27 RCW and <br /> 296.200 WA . <br /> i <br /> i',f /'/� � /� � ��% /[J � _ ��� f�/ <br /> Signatu`re ' ' �Date <br /> � � � � �� �� <br />