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i <br /> ELECTRICAL PER11111T APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES �� --//-D� <br /> 3200 CEDAR STREET, EVERE?'T, WA 98201 �o y��.�a 3 <br /> 425-257-8810 - FAX 425-257-8857 --www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDI7 CARDS ARE NOT ACCEPTED <br /> �C'_�� '4"^Zi n���•c-.r� f11aSZ <br /> PROJECT ADDRECS <br /> -=��. i)���� y�c.��er tt �=� `7t:'�O-`� � � <br /> _��'����c, -� ��1��L�,.:�� 1350 ! /CiU��19�..� Nl.� 52�U �„ rz�.LWt,�{ ��r'� G��Z� <br /> Owner Mail Address City Slatel7_ip Phone <br /> Tenant Mail Address �:ity State/Zip Phone <br /> rl ��- ��i '�'`��- — <br /> Electrical Contraclor Mail Address City S�ate2ip Phone <br /> State License Number Contract Price of Work <br /> �`��L_ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: 1,1P�J�A�_ ����-�� � <br /> I <br /> NOTE: WIRING IM NON-DWELLINGS IS REQUIRED TO FEc <br /> BE IN R.4CEWAYS, MC UR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 hereby ceRi(y that I have read and examined this application and know the same to be liue and �O'�11b-LC�,"� <br /> ' correc'. AI!provisions of laws and ordinances governing this type of work will be comp/eted <br /> whether speci�ed herein or not The granting ol a permit does not presume to give aufhority to <br /> violate or cancel the p�ovisions ol any other stafe or local law regulatrnr�construction or the <br /> � per!ormance of construcnon. That 1 am authorized Uy ihe owner of this property to peAorm the <br /> work lor which application is made and 1 comp/y with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> . . .._._..- _, <br /> I '., - -� �- /�. � �-� � <br /> �11- � <br /> Signature Date <br /> I <br />