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ELECTRICAL PERMIT APPLICA'TION <br /> CITY OF EVER�TT PERMIT SERVICES ;, ._a g-o s <br /> 3200 CEDAR STREET, E`✓ERETT, WA 98201 �'p Sd'3`lOS <br /> 425-257-8810 - FAX425-257-885i —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> ;�a a � C.��,�� F2,�niJ <br /> PROJECT ADDRESS �D� <br /> �'3 <br /> l3�2(y�n� t trc,u��9 v�.� �2z�-� 4�,�r r��2�.� rii�-<��<<T ��i ��53 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State2ip Phone <br /> YLS <br /> � <br /> fz!/�i4Ai(�iziC- 1'F C �l��i 7�itd�t`�lT --�1/ /��/�d�Yi7` �-Zni a�y : <br /> [lectrical Contreclor Mail Address City State/Zip Phone <br /> (t 4�L � A/ � S' / �/1- � (J <br /> State License Number Contract Price of Work <br /> S�Fl1 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � <br /> Description af Work to Be Done: _/���l.t� �%L ✓LV�[,�K �' �() 1�'21� � /1.� � ������y���� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �S c'� <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 hereby certify that/have read and examined fhis application and know the same to be true and <br /> correct. All provisions of/aws and ordinances,qovemmg this type o/work will be completed <br /> whether specilied herein or not. The granting ol a permd does not presume fo give authonty to <br /> vio/ate or cance/the provisions o)any other state or local law regulating consfruction or the <br /> performance of construction. rhat 1 am authorized by the owner o(this property to perform the <br /> work for which application is made and 1 compty with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> � � �� � �� � <br /> � Signawre � <br /> ���3 ( �J`� <br />