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� ELE�TRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVI�ES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 t� _�D -G,� <br /> 425-257-8810 - FAX 425-257-8857 -NNr,v.everettwa.org I <br /> APPLICATIONS ARE ACCEPTED FROM 8 HM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCE?T'ED <br /> �—� i <br /> I <br /> I •�- Z l C-_ �i p t>f'_ ,�{-G' <br /> PROJECT ADCiRESS <br /> <^��'-`l_.�!% <br /> i i c� - / t" il i!= f3��� � '- /�' t!A /�i= ,q1Lr�=-!%.c✓'rT i �.�.9- ��R'?L'! <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mail Address City StalelZip Phone <br /> C/' / G 3 if� --�'< _� :/� l�.��•_i- i.� i Ai�°.�ivi-i�i� �nli ✓C�.9! �!-'r.�_.6..�f�Lr . <br /> Electrical Contraclor b;ail Address Ciry Stat^..2ip Pao�e <br /> �-'%�/G� .: G= �' a�:4�'.� __— <br /> State License Number Contract Price of Work <br /> � �:'�' — <br /> Proposed Use of Building . �ntacl Person (Flan Review) <br /> Description of Work to Be Done: / < <�h� f'i,+� �- �-/l�ii.��=�- _ <br /> , �A�T/�"/� �_/.�'/f'L .f's�7 .E.�ir,�C �J'r`G � fjf'r�[�� /^/}�i(,t� i� <br /> ,I NOTE: 1NIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> •i CITY OF EVERETT LUCAL SALES TAX COOE IS 3105 <br /> �' r hereby oertily that I have read and ezamir.ed(hrs applicsiicn and know the same to bc ir�e and I <br /> ;:orrect. ?tl provisrons of laws and e�dinances 9oveming this type oI wr.rk�.i!!be completed <br /> wne!her speci6ed nerein o�noL 7he granfing o(a permd does nofp�asume to give aulho;ity to ! <br /> �nolate cr cancel the prov�siens olany ether state or local!aw regulating construction or fhe I <br /> pedormance o/construction. Thaf 1 am authonzed by fhe owner o/this properry ro peAorm the <br /> � ' �,vork(or�vhich application is made and I comply with the State Contractors Law 78.27 RCW and � <br /> 296200 WAC. I <br /> (' ,d�-^ L-�-�= ����:�>�G �' <br /> _ _ - <br /> �Sionamre ate <br /> Ev�ur-1 � fi�{ � <br /> � <br /> r— -- <br />