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ELECTRICAL PERMIT APPLICAT�ON <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVEREl7, VVA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATION� ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �i�� I �� ; � �_ �_at i-� i�Ylc k� W�, 1 <br /> PROJECI'�a�DRESS <br /> � � �, (i: c �111 �'i ,��i � i' 11�>! ��. (. �� ��t:(—� �b� ��i. 11 ���.i_i _ ( .�;,. � o�ta l��tl� �1�?C��< <br /> Ownef MailAddress City Stalcl ip Phono <br /> i (� i , r' U.r� . _ <br /> � Tenant Mail Addrcss Ci�y State/Lp Phone <br /> � <br /> r�lli<- i ���� ( � �1(G. �_l�t ���ll:�l '-{ 1"li;c .`� .�v'.{-��i� 1 -.`l'1 ��`�SIL4S Ji�l�� �� 1 ,') `�.( <br /> Electrical Conlraetor Mail Address Ciry State/Zip Phone <br /> H�L,i C.�v`�--��,r�8 4�1� � 3.3U .���, <br /> State License Number Coniract Price of Work <br /> i 4�f1''1 �1 .I�'Y( � l: �, <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to Be Done: 't-�1� P! ��1 :1 (��'V'�I-�'���i)� <br /> NOTE: WIRING iN NON-DWELLINGS IS REQUIRED'TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. /�� <br /> � �S� v V <br /> iCITY OI°EVERETT LOCAL SALES TA:<CODE IS 3105 <br /> 1 hereby:ertily fhaf I have read and examrned this applicati�n and know fhe same(o be true and <br /> correcf. All provisions oIlaws and ordinances governing fhi;rype o!work will Gs complefed <br /> �vhether.pecilied herein or noL Tne grenting of a pemut does not presume fo give authonty(o <br /> violafe or�ancel the provisions of any ofher sfafe or local la�v regulating construct!on or the <br /> i perlormance o!constmcbon. Thaf I am autho�ized by the owner ollhis property to peAorm fhe <br /> work/or which application is mada and I comply wifh the State Contractors La�v 18.27 RCW and <br /> I 296200 lh AC. <br /> rL��' , �-t��-�� _��/z��� <br /> Sigr aWrc afe <br /> �0511 •oo� <br />