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ELECTRICAL PERMIT APPLICATIOt� <br /> CITY OF EVERETT pERMIT SERyICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � <br /> i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> J <br /> I C�,�:`� Flct�T r�U� . <br /> PROJECTADDRESS ���� `J J�_�Z�(,� <br /> J <br /> I'A, f�,ieh 1,�-�1�� �,,;��'oN , !(':;C:- I �1��� j1 �i: . �. c. , r��l.c cf�Eck , ��_�!� � $o�� <br /> Ownef �Aail Address City Slate/Zip Phone <br /> ��Fl(� a�� nN <br /> Tenanl Mail Address City SlatelZip Phone <br /> NoN� - �`�c�v lx�r.l� t',-y C��N F (z <br /> Electrical Con�ractor Mail Adtlress Ciry Stale;Zip Phone <br /> �lili �/� <br /> State License Number Contract Pricr,o(Work <br /> �rr!:,�E F"r�r,��.�� I�� ����cnlct u�Ai ��i��iAr�Salv' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work to ee Done: �� 1�1;U .L C 11tC iA�C`; (C IN��� FOf� �7ER�CjIZ l.l Ci 11T11�C� <br /> Lz; {1 il u .Z C� IRC�uT FC�R -�f'1C'KE ALf1r'tf1S (zRC � R 3 i;� <br /> i <br /> i ! NOTF: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN Rl�CEWAYS, MC OR AC CABLE. <br /> GITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certity Ihaf 1 have read and examined this;ipplication and know the same to be frue anA <br /> conecL All provisions ol laws and ordinances governmg this type o/�vn�k will be completed <br /> whefhcr speciiied herein or noL The g�anling ol a pernut does nof resume to give aufhonf}�fo <br /> violafe or cance/lhe provisions oI any other state or local lau•renu�ting construction or the <br /> pe�Pom�3nce o(construction. That 1 am aufhorized by the owner or this properiy to peAorm fhe <br /> work lor which applicafien is made and 1 comply with the Sfafe Contracfors Law 1827 RCIN and <br /> � 296.200 WAC. �� <br /> i " <br /> � � r <br /> � � <br /> � ����'_ �-\S�=�� � <br /> Signatwc �ate �� � <br /> I <br />