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ELECTRICAL PERMIT APP�.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-5810 - FAX 425-257-8857—www.everettwa.org U "�a'"��c,� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C� ��u_o� J <br /> � 8 � 8 �G�, b�,.� �,,t,.�H w,4 <br /> PROJECT ADDRESS <br /> �au�''u'� �c /'la-��C�7 �7(" D�S- �� <br /> Owner Mail Address City Stale2ip Phone <br /> ��c� �SC '7 <br /> Tenant Mail Address City State/Zip Phone <br /> O� �Zf <br /> Electrical Contraclor Mail Address City State/Zip Phone <br /> ��- 1c�.6.� <br /> State License Number Contract Price of Work <br /> �SiOl�n�t /Stn'7� Vl ��h�v�.rc� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion oF Work to Be Done: I`r�..n ��i r �Y�uL�� �--�it � �1 ,C?il✓+i /.7U� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> �Ci� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �- <br /> I hereby certiiy ihat I have read and examined this application end know(he same to 6e true and �= �Z��-+" —�SS <br /> conect. AI!provisions of laws and ortlinances goveming tliis rype ol work will be completed <br /> whether specified herein or not. The granting of a permd does not presume to give aufhonty to <br /> violafe or cancel tfie provisions of any other state or local law regulating construction or the <br /> per(ormance of construction. That 1 am authorized by the owner of fhis property fo perlorm ihe <br /> work for which application is made and 1 comply with fho State Contrac(ors Law 18.27 RCW and <br /> 29G.?,00 WAC. <br /> i � <br /> ���I J � <br /> I l ? V�,i�, l Z / �L <br /> ignaWre Date <br /> I <br />