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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everelt�va.org <br /> APPLICATIONS P.RE ACCEPTED FROM 8 AM TO 4 PM <br /> ,'i /� �:k�y�- <br /> PROJECT ADDRE <br /> —���.�� �.lr�uJ-e �� J l l � ��" �us�r_e� GUA 5��a� �s 7sy-/z� <br /> OWner MailAddress �—Cily Stale/Zip Phone <br /> ��µL� <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical ContfaCbr Mail Address City Stale/Zip Phone <br /> Stale License Number Conlract Price of Work <br /> �l Cr..Z�9� <br /> Prop sed U of Building Contar.t Person (Plan Review) <br /> Description oi Work to Be Done: /I/�w �U�I"��'� E ���Lf I ��'� ��'"C�•'�-� �C�l��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I <br /> BE IN RACEWAYS, ti1C OR AC CABLE. <br /> ; CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby ceRi(y(hat I have read and exarnined fhis applicafion and know the same to ba frue and <br /> conecL All provisions o//aws end ordinances�oveminc�fhrs type olwork will be complefed <br /> whether specilied herein or not. 7he�ranfing ol a pernut does nof resume to give aufhonty lo <br /> violate nr cancel the provisions ol any ofher stafe orlocal lasv iec�uPting consfruction or the <br /> pwformance o/construchon. That I am aufhonzed by the owner o(ff us property to perform the <br /> work(cr which application is made ann 1 cornply wifh the State ConVactors Law 18.27 RCW and <br /> 296.2004'v,4C, ,i <br /> ��� l, � '�,��1 v��'f ��/ ��/�6 <br /> �� <br /> i9naWre Dale <br /> /• <br /> = P�aS-�37 <br />