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l <br /> ELECTRiCAL PERMIT AF�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRcET, 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 /> I G�.�c�%�� <br /> .�iCrZ�� �V�2i1� ��1y0 i,�� <br /> PROJECT ADDRESS <br /> Ownef Mail Address City State/Zip Phone <br /> ���3 <br /> Mc�dd�eS FsPa�z�:sr, I�?zo C�I'�n�+���:�. c:��[, EU�-F�1`�� (xy<. U25�2C�9- llss6 <br /> Tenant Mail Address City State2ip Phone <br /> P��p�'{c.��� F.l�c`IeZC' .j_v�.r.. ?Z.�� .� �,�..f: Y��- ��d!"C� I I- t� Ct�SZc�3 �-125-2�1'C�- . <br /> Electrical Coniraclor Mail Address Ciry SlatelLip Phone <br /> ��ZES`II�� ��3GN �� �oo_ �o <br /> Stale License Number Contract Price of Work <br /> �55�525�:c_. �.'j-couc'1 <br /> Propos d Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ���S��< <cl'� A ti�D •��::+,�u-i '�� C.SQ„n�.ScS <br /> S�x_�...,d._ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 3S <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that 1 have read and examined this application and know fhe same to 6e true and <br /> correct All provisions of/aws and ordinances govemmg this type o/�vork�vill be r,omp/efed <br /> whether specdied herein or noL rhe granting ol a permrt does not presume to give authonty to <br /> violate or cancel the provisions o(any other sta(e or local iaw regulating construction or the <br /> pef�rmance of constructwn. That/am autho�zed by the owner of th�s p�opeRy tc peAorm the <br /> w,.. lor which application is made and I comply with the State Contractors Law 18.27 RCW and � �/ <br /> 296.200 WAC. �l�(,� / <br /> �--�:-. � ��s - l(� � �-c,�� 3 <br /> Signature � �ate � <br /> / �II <br /> �i <br /> � <br /> L <br />