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ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810 - FAX425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBI7&CREDIT CARDS ARE NOT ACCEPTED <br /> //.3/ �/'cc�r;� /.1ir��¢ <br /> PROJECTADDRESS <br /> /q^�. �.LI�.�°2 /(C� J� .('lti�vY /U.P �/�X� CUiY, / p.vr,. <br /> "��'SLL <br /> IOwner tdail AUdresz City Slate2ip phone <br /> i ��� <br /> ITenanl tfalhECress Gly Slate2ip Phone <br /> � �/ ��'��79�/� ' <br /> //Qux.0 lir,l`".,e� ' ,r�' � �`G �i��.n,� ��i� •.�- r�D !� /y}�2 7.1 -� /�� <br /> ElectnralContrador � �aaanaamss Gry staterz�p , 9�d>� <br /> ,�1,��e �%�� , 5�r,�� ��y 50� <br /> Slate License Number Conlract Price of Work <br /> T/�.C�A� / G!//X �� !:'1 A�,(.,o-h� <br /> Proposed Use uilding Contad Person (Plan Review) <br /> Descnp6on of Work to Be Done: �� ,� � � '/'i� �,r,r/ /fj�,/"�.� � /J�D o�� <br /> � <br /> / � <br /> NOTE: WIRING IN NON-UWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA�CO�E IS 9105 <br /> I hereby certify thal l have�ead and ercminotl thrs applicafion and know IDe same to be hue and <br /> cwrect. A!!provisions o/laws and orr/inances goveming(his type o/work will be comp/eta0 <br /> ivhe(herspa:�ed horein or nof, The granfing o�a permit dces nofpre sumo to qive authonry to <br /> violate o�cance!the pro�?sions of any othe�sfat�or loca/law rogulatirig cwis7rocNon or!ho <br /> peAwmance o!cansfructron. Th2t 1 am aufhonzed by fhe owner of this property to pertorm tho <br /> woik for�vhich applicafion is rrrado and!comply wifh the Sfate ContracMrs Law 7827 RCW arid <br /> 296.2001h'AC. <br /> �9���J.�.��' ���ri,�.�� 7�..z/v�-' <br /> � naWre Q Oate <br /> -- �G� ' ��� <br /> I 'd bES8ES909E ot�yoat3 uotyoy dZ0 �Z0 SO Zi FaLI <br />