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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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDR CARDS ARE NOT ACCEPTED <br /> � J ` 3 ��n � S7- <br /> PROJECT ADDRESS <br /> Ci 50h GV'? /TC � J Z.j �i) C .5T �i/(rL I/ y��U � �'�i9 yz�- zTL-8z <br /> Owner Mail Address Clty Stale2lp Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> �y�ht�lr .�-i�rs �"S'P.d�'cx .3�d/ G�vr.�eT7�i9,�c E✓�nJ7� �r/�'1 `J�'Za/ , h'.t�-2)�-2/ � <br /> EI cVical Contractor Mail Address City SWteRlp Phone <br /> Cl���NSS /y2 LP �DOG�" <br /> State License Number Contrect Pdce of Work <br /> JSPS �GPr,ic �. E-�C�! /s7`�</ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptlon of Work to Be Done: ��i � /7G� /n/� Ci�'Y��/1 <br /> _� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily that 1 have�ead and examined this application and know the same to 6e true and <br /> correct All provisions o/laws and ordinances governing this type ot work:vill be completed <br /> whether speci�ed herein or not. The grenting of a permit does not presume to give authonty to <br /> viola(e or cancel the provisions ol any other state or focal law regu/ating construction or the <br /> peAormance oI construction. That 1 am authonzed 6y the owner ol this property to peAorm the <br /> work for which applicat(on is made and I comply with the Stafe Contrnctors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �=����/'� y zo- o� <br /> Signature Date <br /> �v SaK--O�€�I <br />