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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 4RE ACCEPTED FROM 8 AM TO 4 PM S� �-�.—D <br /> � > C-�v7��5-i3-7 <br /> L...��6� (S��j/G � I�J (/�— _1�o� i/ <br /> PROJECT ADURESS �j <br /> _/-a-r � �)��/, � N' t'V C <br /> Orvner 61ai1 Address City Stale2lp Phone <br /> Tenant Mail Address City Stale2ip Phone <br /> NE�nr���.� �-�2C�Ytc l�'U �cX � ��(� �i�Vu��c� ��� `'��c� '�� 3 �9L� �c��� ���.5� <br /> Eleclrical Conl aclo� Mail Address Cilq SWIe2ip Phone <br /> f-��/V�fZ�� '�Dlla�;'l�' <br /> lalo LiS�—cense Number Contract Pnr.e of Wor4: <br /> �i��MP �/y1r � k,(S/(!'�'��/� <br /> Propose se of uilding Conlact Person (Plan Review) <br /> Doscription ol Work to �e Donc: _����i�- �'� �-� / <br /> �� 'T r���_j���,� r <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEVVAYS, MC OR AC CABLE. <br /> C17Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i ne��ny ce�t�r,thaf I ha��e reaU ond exarnined this application end kno�r the same fo be frue and <br /> correc[ All provisions ol laws and ordinanc2s go��enung flus type o!work will be completed <br /> �rhether speci(ieAherein or noL The granting o(a pernuf does nof �resur.ie fo give authonty to <br /> violale or cancel the Fuovisions o/any other state or/ocal law re�ulofing construction or fhe <br /> per;omiance o/const�ucfion. Thal 1 am authoiized b} the o�rner of this property fo perfonn the <br /> work lor�rhich applicafion is m�d�and 1 cornply�rith fhe Stafe Confractors Law 1827 RCW and <br /> 296200 41�AC. <br /> 1�,/1 �f �. �_ n <br /> 1��} �it�1��7� �� ,� 0 i <br /> —� ,9,ignature Date—� - <br /> y' // <br /> � ��� .> 13 � <br /> �=�� <br />