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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE7T 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 <br /> �Z � Pf�t..vv, � .c <br /> PROJECT ADDRESS <br /> �l q'1/ ��(� ,51(Jlf 6= <br /> Owner Mail Address Cily Stale/Zip Phone <br /> Sy-� t <br /> Tenanl Mail Address City Slate2ip Phone <br /> yL�30.3 -vt,�� <br /> E2C �(6c � zZ 2c,(,LI..� (�•�,� G—.Ju� G14 ��'.� <br /> Eleclrical COnt�aclor Mail Address Cily � Slate/Zip Phone <br /> �=R� E� ��- 5�YC� — <br /> Slate License Number Contracf Price o(Work <br /> �G�3-��sj�T.¢L-- � — <br /> Proposed Use ol Building Conlacl Person (Pian Review) <br /> Description of Work lo Be Done: ll/Lhi ��L //k/O S/f.�K.. �[�ii f <br /> �[��Q,_ �i� F'3�4 vUd�(S <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 3705 <br /> 1 he�cby certily tl�at 1 have read and eA.vnineA this applicafion and kno�r fhe same to he true and <br /> cor�ecL All provisions ollaws nnd oidinances go��emmg this type al work iei!I Lo cornplefed <br /> �vhetlier specilicd he�ein or noL The gran6ng ol a permd does nef resume lo give aufhonty fo <br /> t�iolafe or cancel fhe provisions ol any ofher sfate or Iecaf la�v re�u�fing construction or the <br /> pe�(ormance o/conshurfion. Thaf I nrn nufhc�i[ed by Ilre o�rner o/Ihis property to peAonn the <br /> �vork lor which application is made uud I canpty irith Uie Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �'��. /��5�.1� <br /> Signawro Date <br /> / <br /> ���'� -�`�d <br />