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ELECTRICAL PERi►iIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wvrw.everettwa.org <br />� �-�s-c y <br />[oy��,��1 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />( � `� �. (.' ( L i �,T <br />I�:��rlX�3�1�]7:7�� <br />i_l-I�A� PG C'�i.� X I���-I'1 Evc-e_ ET� ti� R`� 5,-%v ��_ � z�>��.3 -� I i� I <br />Owner Mail Address City State2ip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />1�71�<�ri [ �.�C,,—�_' �L ,'c; 1?�xjr��» i,n�'i: `����t�A`, �vN�i<;%S`�(`-�z5 1 ���� `'�7t-s <br />Electrical Contractor Mail Address Ciry State2ip � Phone <br />:t'��'"�'rt �i �i�i��(i. i_" <br />State License Number <br />4�l,llrT� I-��t�il��/ -�'j.=-,i1 ,.=���(�:- <br />Proposed Use of �uilding <br />Contract Price of Work <br />Conlact Person (Plan Rev�ew) <br />DescriplionofWorktoBeDone: �,'�V �I� �Nii �,t.l'(-,�� /li)t <br />NOTE: Vt IRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. }j C.< �G.� _ <br />� ) J 1L/ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! herebvi certi/v that 1 have read and examined this applicaticn and know the same to be true and <br />correct: All piovisions o/laws and ordinances govemmg this type ol work will be completed <br />wnether specibed herein or neL The granting e�a permit dces not presume to give autAority to <br />violate or cancel the p�ovisions o( any other state or local la�r regulatiny construcrion or the <br />pedormance ol ccnstruction. That I am authorized by the owner ot ;his property to peAorm the <br />�vak (or �vhich application is made and I comply with the State Contractors Law 7827 RCW and <br />296.200 WAC. <br />t� /. ,_ _. �' �� <br />