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C � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY t?F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACC"PTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NGT ACCEPTED <br /> i�t c� � ' �.u.�r���- �u�,-� ��,o i <br /> PROJECT ADDRESS <br /> } . 4� -4ad-a3cl� <br /> ��c4n, �1.�`��2 ' ��Ai�02a- �2q�v►o�2 ��'�a�c`�� v.�c�5�1. <br /> Owner M3il Address City State2ip Phone <br /> Ten2nt Mail Address City S:ate2ip Phone <br /> �,a. <br /> c�c��2 �-- �a i4e� �a ����.t �►a ��(o <br /> Electrical Contractor Mail Address Ciry Slale2ip Phone <br /> State License Number Conlract Price of Work <br /> 1 � �ti sov�c�.� ��o�v�� 40`l5-4'�l` -�3�� <br /> Propose� Use of i ing Conlact Person (Plan Review) <br /> \ \ {� 4� �' -I I �.5 <br /> Descriptian of Work to Be Done:�hD� D�I�T' '1-Q M1. � (l � C( �3C�..1� �A.-'�'UT <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cert"y that/have read and examined this appiication and know the same to be true and <br /> correct. Al!provisions of/aws and ordinances governing fhis type of work will 6e complefed <br /> whefher speaGed herein or not. The granting of a permd does not presume to give authonty to <br /> vio/ate or cancr.l the provisions ol any o(her state or local/aw regu/ating construction or the <br /> pedo�mance of construction. rhat 1 am authonzed by the owner of fhrs property to peAorm the <br /> •vork for .vhich application is made and 1 comp/y with the Sfate Contracfors Law 18.27 R.CW and <br /> 290.200 WAC. <br /> _ � 1�� 0���74 <br /> Signamre� Date <br /> €O`lOF-O f�i <br />