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/ - <br /> , <br /> . . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 rb �y`d y <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org C 0 (�/0�-0�3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCE.PTED <br /> 3� � f\�;�_a\v;Q Zon.1 Ev�a�tt W(\ n�,��;'3 <br /> � <br /> PROJECT ADDRESS <br /> \�'Z�a:���������� 0..\c� .JG���.0 L.u,21�5�1�:�-Y'. �l�b.�2�2'�ec�l <br /> Owner MailAddress City SWte/Zip Phone <br /> c�w��.z oc�v�,ec� �1a7 tyec�+��e�z 2�1 l_vezCN w4\ '-�%3S - I <br /> � Uti;�::.�3 a•�a �t���5 <br /> Tenant Mail Address City State/Zip Phone <br /> i;uJ-i\`L�Z � <br /> Electrical Contrac'7r Mail Address Ciry State/Zip Phone <br /> �� � �� t� � � <br /> tate License Number Contract Price of Work <br /> '�,��c L�n � \.. C2e���c\e�ke uw�1`�Z_ <br /> Proposed Us of Building -' Contact Person (Plan Review) <br /> Descriplion o(Work to Be Done: i ,, r - ; � � <br /> ��1"5'taL� C�� �: -:�v��� ��\� • c �a� a� c�\c\ L�T <br /> � -\�1! C c -\ h� � -� u • ''�� � \ �n��� \ , � ,�rc��vr\ \c��s; �u \>� c.r \�a\\1.��c. <br /> � �� —� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN FACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceiti(y that/have read and examined fhis application and know the same to be true and <br /> correct All provisions ollaws and ordinances yoveming this type of work will be comp/e(ed <br /> whether spec�(ed herein or not. The granting ol a permd does notp resume m give authority to <br /> v�olate or cancel the provisions of any other stafe orlocal la�v regu/ating constrt�c7ien or the <br /> pedormance of construction. 7'hat I am authonzed by the owner o/thrs property to perform the <br /> �vak for�vhich applicatien is made and/comp/y with the S(ate Contractors Law 18.27 RCW and <br /> 296.200 WAC. �h <br /> _- -, / <br /> =- -- -,-. ___- -_.; ,�%1 <br /> , l�\\� .\c�ti. • . ,,.,�c i•,,.; a:,,�,��, o� ZASZgc:y ,� I V <br /> '� 5ign`Tre—� Date �' <br />