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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETI" PERMIT SERVICES y ��p.�� <br /> 3200 CEDAR STREET, CVERETT, WA 98201 <br /> 425-257-8810 - FAX425•257-8857 -www.evere;twa.org (,'U80�—I g� <br /> APPLICATIONS ARE ACCEPTED FROM S AM 'i'U 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 210 � G� �.,1 �� � <br /> PROJECT ADDRESS <br /> j �..,-•-� 1(`� L �c. �� <br /> Owner Mail Address City State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> � ZO G <br /> �asc. �.� �c.��', � �i �! � � �-',� i)oY T �-.�< � nc ��• _ ,ti . S �, ��► 31-3 124 <br /> Electrical CoNractor Mail Address City � �tate/Zip Phone <br /> C1,o, 5�e.t� 'C� �002 ��6,00 O <br /> State License Number Contract Pnce o(Work <br /> 3 �,.r: �- L o., a � �.h�, 4 n 4J �� t <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description of Work ta Be Dane: S.� S�A�1 �' r t 1�� �r .�. �y �i-F{ r. <br /> � v �`+ <br /> -r _� ,, r . _ , . . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���u <br /> � 1 here6y certily thaf I have read and examined thi;application and know fhe same to be true and ����� <br /> IcorrecL All provisions of laws and ordinances goveming thrs type cI wcrk�vdl be cempleted <br /> �vhether speci6ed herein or ncL The granting of a permd does not resume to give authonty to <br /> violate or cance/tne provisions o(any other state or local law reguPting consfruction or the <br /> � pedormance o(consvuction. That I am authonzed by the o�vner of this property to perform the <br /> werk lor�vhich applicatiOn is made and I comply with the State Centractors La�v f8.27 RCW and <br /> 296.200 W,4C. _ /1 :�- <br /> / } ' <br /> � ���� '1 � 3a���' <br /> 5� � a ure ' � Date <br />