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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 EO �J�—�� <br /> 425-257-8810 - FAX 425-257-6857—www.everettwa.org C� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S '-7�O LS <br /> �1�� �;�uv�l �1� . ��e���+ w���-a,�l <br /> PROJECT ADDRESS <br /> J �n�. M�-0�9 i SL� 2 �41 S �.v�[-u�r f��!'. �I�r'�tt �a19-��1 `�25 2s9 �t3� <br /> Owner Mail Address Ciry Stale/Zip Phone <br /> Tenant Mail Atltlress l:i�y Slate/Zip Phone <br /> ( sl3uG�1t��,�t 7ay �k�S <br /> �2CU..�Ii� tn. lvtC C!� (o� FJet�'FI- W��-�� 25F��,� <br /> Electrica ContraCtor Mail Address City StatefZip Phone <br /> x--C.la�t i�t cl �-`r-�`.l� � J( �« _ _—� <br /> State License Number Contract Pnce of Work <br /> C�^G�L;IL-t'1 i'�l l.�i�'1 <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descriplion o(Work lo Be Done: �G�17�_�-O� �`1'1`� T1�QG�w'F�" ��\rr��V`G� <br /> � <br /> ^ .� ,�,.n� .t� �-l.�ri, �M <br /> NOTE: WIRING IN NON-DWELLINGS IS REGUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC. CHBLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 ��J�� :S�l� <br /> i <br /> 1 hereby certily thaf I have read and examined this application and know the same to be true and v <br /> correcL All provisions ol laws and orciinances govemmg this type ol work wiN be completed <br /> whe(her specified herein or not. The gronting o!a pormd does not presume to give authonty fo <br /> vio/ate or cancel the provisions ol any other state or local law regulafing construction or the <br /> peAomiance ol consfruction. That I am aothonzed by the owner ol this property to perlorm fhe <br /> work Ibr which applicafion is made and I compty wifh the Sfafe Contractors Law 1827 RCW and <br /> 236.200 WAC. <br /> � � � �, � � <br /> � 1 l ��' �-� � 5 �JC� <br /> � - �� � � � ° <br /> —�gnature � a�e <br /> l_ <br />