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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 — www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />29'z �3 C �i � !{,! �_ <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Ci�y <br />State2ip Phone <br />y 2-f <br />�/,�Z�Tf F�*( DQAuI.� c S Z�i 2yi F.Q�n Rv'v p,'�Qe� �15� 2 E 30`l- l;% 1 <br />Tenant Mail Address Cily Stale2ip Phone <br />Eledrical <br />{h�71 7c �iyiJ'�'Zii S <br />State License Number <br />Propased Use <br />y li�lty N <br />Mail Address <br />City <br />1i3 <br />3��-irr..� <br />State2ip Phone <br />�.�i n�. cn <br />Contract Price of Work <br />213 �3�}�? -Illn�l <br />Conlact Person (Plan Row=w) <br />Descnption of Work to 8e Done: y�PG2M7 E £-w S'n.a G ��t e<, �z �ta� Sy S Tt� �CniM ce. � <br />k-C�`(Vw� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />FEE <br />I hereby certi(y fhaf I have 2ad and a.ramined this applicafion and know Ihe same to be true and <br />conect All provisions ollaws and ortimances govemrng this type ol work will be completed <br />whether specihcd herem or not rhe granling ol a permd does not presume to give authonty to <br />v�ola(e or cancel fhe provisions ol any ofher stato or local law mgmafing rnnstruclion or the <br />performance olrnnslrucfion. That 1 am authonzed by fhe owner ol fbis property to pedorm fhe <br />work lor which app/ication is made and 1 compty wifh the Sfate Contractors Law 78.27 RCW and <br />296.200 bYAC. <br />LI �Ti�tu <br />