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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI7 SERVICES <br /> 3200 CEDAR STREET, EVERETT, '�VA 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 CAR�S ARE NOT ACCEPTED <br /> .�050o aW� q� SouTH �v'ewE�i wA,qY�2a/ <br /> PROJECTADDRESS <br /> �03 4�f�N��l l050o rFwr 9g sbuir� Ev�2E7T l,�A 98��y (�)��c -.�5�7 <br /> Owner MailAddress City Stale2ip Phone <br /> �(fCFoRMAti /�1xF4nl SRIWtE AS owN�R <br /> Tenant MailAddress City State2ip Phone <br /> � N� =��Fs lp��s ow�1��c Au�s• r�ku.,�� wA q�i�tf� �25 z�� i�W <br /> ElectricalConiractor MailAddress Ciry State2ip Phone <br /> 1�1iN1�G-U65PI �xr' /b-zi ��� � 1 �00.�— <br /> State License Number Contract Price of Work <br /> l'o►mm�c��t, )c�u� iY� . �-An�N <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to 6e Done: �NSiALI. la L�[�TS �h �� t 4 �a� 1��U�1Z SCt�JT <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�ODE IS 3105 <br /> 1 hereby ce�tily fhat I have read and examined this applicafion and know the same(o be true and <br /> conecL A'!provisions o/!aHs and oidinances govemmg this type ol work will be completed <br /> whe�her spealied herem or noL The granfing o/a perm:'does nol resume to 3ive authority to <br /> violate orcancel fhe provisions o(any otherstate orlocal law reguPting construchon orlhe <br /> peAormance o/consfruc6on. Thaf 1 am authonzed by fhe owner o(this property to peAorm fhe <br /> work Ior which epplication is made and 1 comply wifh tho State Contracfors Law 1827 RCW end <br /> 296.200 WAC. <br /> / — O <br /> pnaWre ate <br /> �_��C% -/�7 <br />