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; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, E.VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PYI - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> l ZI Z �bnn �/�Z�� �� <br /> , PROJECT ADDRESS <br /> ( /�J�El !6Zv-� lNl � �'�c�/L�-e._ I Z(Z L o w+6�� �G/Y.c grfj'" �' i�ZO/ <br /> OWner Mail Address r;p- State2ip Phone <br /> s� �2s 2 s%- s��3 <br /> Tenant Mail Address City State/Zip Phone <br /> P�'2/�-�,,r,� LzGGiY�<G �o.l3ox �6s` ���l��s �/�- °��'ozv <br /> Electrical Contractor FAail Address Ciry Stale2ip Phone <br /> PyP_�f�1.� l0�7 �w ;oc� v. <br /> State License Number Contract Price of Work <br /> Froposed Use of Building Contacl Person (Plan Review) <br /> Description of Work to Be Done: � �U �^ / � r l � �� � vl � ��G%�/Vj ' �/yvb¢- <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEc <br /> BE IN RACEVJAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I heraby certity that I i�ave read and examined this application and know the same fo 6e true and <br /> co�recL A/l provisions of iaws and ordinances goveming this rype o(work will be comp/eted <br /> whether speafied herein or not. 7he granting o)a permit does not presume to give authonty to <br /> violate or cancel the provisions of any other stare or/ocal law regu/ating construction o�tbe <br /> performance of construcGon. rhat/am autho:�zed by the owner o(th�s property fo pe�lorm the <br /> vork for whicn application is made and!com�ty with the State Contractors Law 18.27 RCW and <br /> 296.20 WAC. <br /> <,.�-�ljl L ,��� l 2--�� o S� ///���� <br /> ignature Date / <br /> ��� �2 <br />