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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-vwvw.everetlwa.org <br /> APPLICATIONS ARE ACCEPT�?FROM 8 AM TO 4 PM -DEBR&CREDIT CARDS ARE NOT ACCEPTED <br /> r9o� �� u� 7� A � <br /> PROJECT ADDRESS <br /> �F�,T� 5��� PoB zZzSlv .�,M� 5`��zz <br /> OWne,- Mail Address � Clry Slate/IIp Phone <br /> .�!/�/ �FVe�S <br /> (�1Ur- �5�;�4N 5,1���H � 4iJc�.�// �nll�- 98�( uzt-z3z-�rZ <br /> Tenant Mail Addrese City SlalelLp P�one <br /> ' /�CY7 CzflJl�f/C!j'f�srl� :LEC �(27Ci fbB:US SAXMJ��M�II y�h 9Pzi � �'2��?� <br /> EleCtrical CAnVaCtor Mail Address City SfateZ,r, PAone <br /> ��..Y GG�� 9 �� : I.,, I�s/_ �zl�—� <br /> State License Number Con ct P�ice af Work <br /> SA KP�[-� <br /> Proposed Use of Building Contact Person (Plan ReWew) <br /> Description of Work to Be Dane: ApA31'� (, f�31 ui,-r5 N Foa E'�c.P7AtL�'S -� �Q�N�[_ <br /> u�A ic.�'Y'_ T14/JI� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CO�E IS 3105 <br /> I hereby certify that 1 have read and examined this application and know the same to 6e true and <br /> correct. All provisions ollaws and ordinances goveming this type of work will be completed <br /> whether speci�ed he�ein or nof. The granting a/a perm�t does notp resume to give euthority to <br /> violate or cancel the provisions o/any other state or local law regulating conshuctlon or Me <br /> peAormance o/construction. lhat I am authorized by the owner o/this p�opeRy to per/orm the <br /> wo:k lor which application is made and I comply with fhe Sfate Contracfors Law 18.27 RCW end <br /> 296 00 WAC. <br /> 1 <br /> �� � , � � ''! 'vl�� /6 � <br /> Signa ure D le � <br /> q ► D� <br />