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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 y _ ay..�p <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org <br /> ��9ou ��aR <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> -1 5 a c�ow„� iDa��� <br /> PROJEc;T ADDRESS <br /> T0.u�n� �-Gv`�,-Cc15a`i1 ��� GCa�..S�n {�' Ei���� 1.�11+4 ��J-3g7- 'l7 2, <br /> Owner Mail Adtlress <br /> City SWte2ip Phone . <br /> Tenant Mail Address City State/Zip Phone <br /> P�ESTw.� Ft-F��R-��i'N c 2Z3Zs .Kd�.�...�s fltw-Eue-�z�" lsd �j�2 d 3 k2S 790 ?�30 <br /> Electncal Contractor Mad Address Ciry State2ip Phone <br /> �jZCS��z ��;, cy f�oo_co <br /> Slate License Nrmbcr Contract Price of Work <br /> Jt � <br /> Proposed Use of 2uilding Contact Person (Plan Review) <br /> Description of Work�o Be Done: (-�'b"f" '�Y �n C �1� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE, <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> l hereby certity that 1 have read and examined this application and know the same to be true and <br /> carect. All provisions o(iaws and ordinances govemmg th�s type o(work will be comp/eted <br /> whether speci�ed herein or not The granting o/a permrt does not presume to give authonty to <br /> violate or cancel fhe provisions of any other state or local/aw regu/ating construction or the <br /> performance o/construchon. That am authonzed by the owner o(th�s propeny to peAorm the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Sign�e�� �� �- C-�— � 1 / ���� /� <br /> Date � , I �� <br /> l/ <br />