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ELECTRICAL PERM[T APPL(CATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEC^R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT & CREDI� CARDS ARE NOT ACCEPTED <br /> �� � �f0� �f V�' <br /> PRCJECT ADDRESS <br /> � ✓G Q-E � (/LJ/1 _ ���J� `� 1 S� �S�� 'SS�� <br /> 'i��v�� ��Nc" /SZi N��? �l�c c <br /> Owner Mail Address Ciry State2ip Phcne <br /> Tenant Mail Address Ciry State/Zip Phone <br /> �L-L (= -� //o�tiLC�.� NC('� <br /> IElectrical Contfactor Mail Address CiN State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Buildin9 Contact Person (Plan Revie�.v) <br /> , _ <br /> Description ef Work to Be Done: �i,"r 1,�� C�o- c �i a . -� r :�'�'T ;i ,�_ fi�' � f"�t V 1-c�'� <br /> �.�� ��[�'L J�-'LL OS ID bL �>v£✓L,l�' "T i c C-�c�E .Ei I�c-k L 7�s T lT�,'C'ti <br /> � . <br /> f� y� r��c�-��� ��•d� �ti��P����� <br /> I NOTE: WIRING IN NON-DWELLINGS IS REqUIRED TO FEE <br /> iBE IN RACEWAYS, MC OR AC CABLE. <br /> �, CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I I hereby certity thaf 1 have�ead and examined this application and know the :ame to be true and <br /> ' rorrecL AI!prev�sions of laws and ordinances goveming(his type ol werk�.+�dl be completed <br /> � �vnefher spec�hed herein or not The granting of a permit uoes not presum,e fo give authoriry to <br /> lviolate or cancel the provis�ons af any other sta!e or local!aw regulatiny c�nstruction or the <br /> i peAormance o(construction. That I am,au(honz�d by the owner e/fhis p�operty fo peAerm the <br /> i �vr.rk ler wnich application is made and I c�mply wdh the State Contrar,cers Law 182, RCW and <br /> i 296.ZOO WAC. <br /> I - �l� �r? ..: 7 G5 �� ! <br /> �. Slgnature �ate . ) � � I <br /> � ,';�� ' <br /> _, <br /> � <br />