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ELECTRICAL PERMIT APPLICATIOfJ <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT, WA 982U1 <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 /> 1��`, � �L�� rC��--� <br /> PROJECT ADDRESS <br /> �yz��� 1�=�uo3 Ev�'�,�('��'�• `"�� FU�('U� ��.A- `(fl�o� .�'o y�2�-i3zs— <br /> Ownef Mail Address Ciry State/Zip Phone <br /> G1J�ct?�.<<�. I�GU3 ��-�_ .��< <•�� c,�c.� .fver-�' wEl- �tC.zc� � 3C-�r�-q2�(-�32s <br /> Tenant Mail Address City State2lp Phone <br /> s .�� �'1�� Ii � �,:�� ����� �l � S <br /> ����(-cr�� ����'uU���1�c ��UE3(��...� 9`l � i � t CCu� ,c��Y,Z -�3z � <br /> Electrical Contractor td ' ddress Ciry Slate/Zip Phone <br /> �,I�Y_�� sc�,t� � Y <br /> State License Number Contract Price of Work <br /> ��� D�<<(�rs �. ;� 3,4( �r�� �� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriFtion of Work ta Be Done: �'�ST"L�l ���^���� �U� ����`�"`� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, tiiC OR AC CABLE. � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I Yereby certi/y ihat/have read and examined this application and know the same to be true and <br /> correct. All provisions ollaws and ordinances governmg this type o(work wil/be comp/eted <br /> whefher specified herein or noL The granfing of a permd does not presume to give authonty to <br /> violate or cancel the provisions of any other state or/ocal law regu/ating construction or the <br /> peAormance ol construchon. That 1 am authonzed by the owner ol this property to peAorm the <br /> work for which application is mado and 1 comply wdh the State Contractors Law 18.27 RCbV and <br /> 296.200 WAC. <br /> ,� , <br /> �,:�,�..�, ` ��-.�3�vs n �l3 <br /> Signamre / Date �f` / � <br /> r Jc�' <br />