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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEUAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAK 425-257-8857—www.everettwa.crg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� Z Z C�--,�ia,�� �� �= <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> � , ��"� 1 7 1— J1U� 1=c,�c ��L� L I � ��� J �j 11� AJ� LJ L �f�-�Hw��� C�.-� . <br /> EleclriCal Conlraclor Mail Address City State/Zip Phone <br /> � �fZ�—z �z— FS�7 �K <br /> (,J c��(� 1= —LS � 2 � v �= ^ <br /> Slato License Number � I �I'; / Conlract Price of Work <br /> 1 I--.� �� <br /> Proposed Use of Buiiding Contact Person (Plan Review) <br /> Description ol Work lo[3e Done: �� \�-�' 'y,� � � t J J `� V- ' 1 S C. , <br /> �� A-� ,v�—.�-^�=—L.��v� � "`�S <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIREDTO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby certi(y fhaf I have�ead and examined fhis applicnfion and know(he same fo be We and <br /> correcL All provisions ollaws and o�dinances govemmg tlds type oI work will be complefed <br /> �vhefher spec��ed herein or noL The granting o(a pennd does not presume fo give aufhonty to <br /> violafe or cancel the Provisions of any other state or local la�v regu/aGng consfrucfion or fhe <br /> peiformm� o/construclion. That 1 am authonzed by the o�rner c/fhis property to pedomi the <br /> work lor��ii h npplicafion is nmdo and 1 comply u�ifh the Sfafe Contractors Law 1 B27 RCW and <br /> 29G.10� C. j <br /> � ,� � <br /> � / <br /> �� �— �7 �� � � � � ,� ��j`� <br /> � Signawre D te ' �i ,l �� <br /> U L <br />