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ELECTlRICAL PLRMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 C[DAR 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 /> � � I � lAl V=uc�e�} ,l.7rA11 i�Jr�.v <br /> PROJECT ADDRESS <br /> ��-2�1- �'tU�1 ll�-l� (,J, Evere� ,Llul�l�ici� kix�c�l- (�+� , 9n��,� <br /> Owner A"aii Address City Slate/Zip . Phone <br /> � ��- ��4 ��` � YPn� �it,va. ��1-� I�.�(�olU AIe��P1J'�c SS�IZ.� <br /> Tenant Mail Address Ciry State/Zip Phone <br /> �.11lQ G���C�(�d�C ��VO ��'lr�l� C�-ri'�'1 �'f1WCiy �lk"�'"� l.J/1- 1��� �({2���07"�'.32 <br /> c <br /> Electrical �riracto� Mail Address City State/Zip Phone <br /> �LLE L C.I �1 I,1.�4 ��5�,5(7�� <br /> State License Number Contract Price of Wurk <br /> �{ ; <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description of Wark to Be Done: COnS'�k[�;� b� �Pt,1 ��t i1��K . GP�r',r4� F�c�W�'r ��t ��t��'��i <br /> I NOTE: WIRING IN NON-DWELL.INGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> '�� 3927s � <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I here6y certily thaf!have�ead and examined this application and know the same to 6e true and <br /> correct. All provisions ollaws and ordinances govemrng this rype of work will 6e completed <br /> whether specilied herein or noL rhe granfing of a permrt does nol presume lo give authority fo <br /> violate or cancel the provisions ol am�other state or Ieca/law regulating construchon or the <br /> .'i perlormance of construchon. That I��m authorized by the owner o(this property to perlorm the <br /> �voik ior which application is made and/comply with the Sfate Contractors Law 18.27 RCW and <br /> .I 296.200 'NAC. <br /> ," y _ �:f�-= 31�� �k;5" <br /> i � �Sign ure Date <br /> ' �� ` � - %� <br /> � <br />