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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />��(i� Nard�son �a4c1 <br />PROJECT ADDRESS <br />��'J(�Ir�l� �fC <br />Owner <br />I�r9lran (n� .. <br />Tenant <br />i E��S` I�am�?i u� Frl <br />Mail Address <br />City <br />6��5 l�n.��(r�n �'�- f"vtr¢11 <br />Mail Address <br />City <br />W��J&�04. <br />Slate/Zip Phone <br />UA <br />State/Zip <br />Phone <br />tlFf R2�?i�l�r1. U�', f�3(� �ibsn� �d � {�ti�rei� �va �3�Zo3 yZl�- Z��7-p6ro <br />EleClr;�al Contractor Mail Atldress City Slate/Zip Phone <br />rIG�P � � � 21 �°��• <br />State License IJumber <br />B- �;,M�,�;.,� <br />Proposed Usr. of Building <br />De :cription oi Work to Be Done: <br />I a� vo�rN�,t F�n ro K�ior,s,� 2 I� <br />NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO <br />EE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />yS� <br />l.ullifdCi �(il.d 'ui �vrvin <br />eoN l . cA<< <br />ContactPerson (Plan Review) <br />I hereby certily that I have read and examined this application and know fhe same to be true and <br />correcL All p�ovisions of laws and ordinances goveming ihis fype o( work �vili be completed <br />whefher speci6ed herein or not The granting ol a permit does not presume t� give au(honty to <br />wolate or cancel the provisions o( any other state or local law regulating cone:ruclron or the <br />periormance o� construchon. That / am aufhonzed by the owner of this property to peAcrm the <br />work for �vhich application is made and I cor�pty wdh the State Contractors Law 18.27 RCW and <br />296.200 W� ,�� � <br />i .- � <br />i� �g�r�� <br />FEE <br />� <br />� ��� ��� <br />