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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 ACCEPTED <br /> / c�1 �� Nw., y 9 �i D <br /> PROJECT ADDRES <br /> � 12'--- .A Co ��-! � r u.✓ Co i a l e u���/rt� �:,�� S <br /> Owner Mail Address City State/Zip Phone <br /> Cf ZJ� <br /> �G� torlaAti< ct ���c� Me-��✓� 53'�+�'- /f-5 J/o. e�� .�_.��i_� 5 347' S 7�3 <br /> Tenant M11ail Address Ci.ry State2lp Phone <br /> �{73`- <br /> ��iry Ncov cc 7Yec I/4.��s�w ?./ ��'c.�F{ l,�,0 _5$Zo5 7Z�-S83S- <br /> Electrical C tractor Mail Address City Slale/Zip Phone <br /> vu <br /> /.�:,fl Y.✓i !� S J L 3 i /O c� � <br /> State Licens Number Contract Price of Work <br /> �. SrILVt P�O�h � <br /> Proposed Use of Buildi g Contact Person (Plan eview) <br /> Description af Work to Be Done: i,�,S�4/ � (I) S � ,.,i r � S.•��� �,✓ �K.5�:�. _�n lc <br /> 5 _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 hereby certify that/have read and examined fhis apAlication and know the same to be true and <br /> correct. All provisions of/aws and ordinances goveming this type of work will be comp/eted <br /> whefher speciued herein or not The granting ol a pe:md does not presume to give aufhonty to <br /> violate or cancel ihe provisions of any othe�state orlocal law regulating construction or the <br /> periormance of consirucLon. That 1 am authcrized by the owner of this property to peAorm the <br /> work fqr which application is made and I comply with the Statz Conlractors Law 18.2?RCW and <br /> 296.200 WAC. f � <br /> ���i �-/�OS` <br /> Siynawre Date <br /> �5��-3� <br />