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ELECTRICAL PERMIT APPLIGAYlON <br /> CITY OF F'JERETT PERMIT SERViCES <br /> 3200 GEDAR STREET, EVERE'I�T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �- l Cj --O , <br /> l lZ/ �� `i � ; , -� ! l '�'i�?lI ;{,, c . <br /> PROJECT ADDRESS <br /> i> <br /> C rT�� �a= l.�i� i� t �r; ('� '�� . 1�>1�,��_ �- r-� c �,�v�� <br /> Owner � hlail Address City SWte/Zip Phone <br /> Tenant Mail Acdress Cily SlalelZip Phone <br /> ���/v7/�� �� L�.4��"�-!L �o (3c,�C`Tb> �M��u�S �/l�i'- �'S'o 2i� Zc� � Z-u3� <br /> Eleclrical COnl�aclo� Mail Address City State/Zip Phone <br /> ��?���P�i� lU 7 7C LJ I�O D �= <br /> Stale License Number Conirect Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to 6o Done: ��y —� �Q�� ( ZP�' � I l�C.�Li� �iL �����tS-L <br /> (/�J��'I.sl� _F. — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR.4C CABLE. <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I !hereby cerli(y thai I have read snd examined thi;,app;ica;ion and know the sarne to be true and <br /> ! correct. All provisions olla�vs and ordinance�govemin�this fype o(work will be complefed <br /> (I whether specilied herein ornnL The c�ranCng n!a pennd does nof presume to give aufhonly to <br /> violate cr cancel the�rovisions of any other stafe orlocal law regulafing construc6on or the <br /> perlonnance o/construction. That 1 am aufhorized by fhe o�vner o/this property fo peAo�m fhe <br /> work Ior which app!ication is made and 1 comply with the State Contractors Law 7827 RCW and <br /> 296.Z00 WAC. <br /> _- � / ' � i <br /> � <br /> =.`___7` 'i 1;' � /�v7 <br /> ��� <br /> SHJnature � ` Uale ' ��� <br /> !� ' ' <br /> � � ��/ � <br />