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E!_ECTRICAL PERMIT APPLICATION <br /> CITY OF E'VERETT 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 ACCEPTED <br /> � <br /> ROJECT ADDRESS ���� ��� �`���� � �� <br /> /, 1� <br /> �i�'� <br /> ��b��— 17i� � �`� µ'� �C � �'��ay <br /> Csvner Mail Address City State2ip Phone <br /> Tanant Mail Address City 5Wte/Zip Phone <br /> /VjpG �NA- ��z�►- �-z� aa�37 �a�'-� %� � S. � �--- <br /> Electrical Contracto� Mail Address / '��— O late/Zfp �� ` Phon <br /> �p L /���(�/�—� � K ' /�r7�/�3 :� ��— J <br /> �� <br /> St2te License Number � � Contract Price of Work <br /> ��J-� ,� �,u/�.�v�C�-�z��i, y��/�i/� �i�✓f� <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of Work to Be Done: ��" �?� � L � ` '� �� (J- G• �L/� � '/ <br /> 1��� l��� , <br /> — /,J�K /� �l� / S a- � � �,�A-� ��,�,J� <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 hereny ceRify that 1 have read and examined this application and know the same to be true and <br /> cor�ect. All provisions o(laws and ordrnances governiny this type of work will be completed <br /> whefher specified herein nr not. The g�anting o/a permit does not presume to give authority to <br /> violate or cance/the provisions ol any other state or loca/law ragu/ating construction or the <br /> performance o/construction. That I am authonzed 6y the owner of!h�s property to peAorm the <br /> �vork fo�which app/ication is made and I compty with the State Contractors Law 18.27 RCW and <br /> 296. IhAC. <br /> �L(,�,�o� jl— ,`}--� � <br /> 3�fiatu e Dare <br /> Eoy i�-o�� <br /> � <br />