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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CED.4R 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 � �--I�7"Q�"J <br /> �oga -0 <br /> �� � �. �/�kCs � �� <br /> PROJECT HDDRESS <br /> �25-/'�•?- 98 s- <br /> f1-✓ceo � Gf��� �� . C� i��, �oo� /NL►��, ✓U� �EDx-ro,�r�, w� 9'Bo.sZ <br /> Owncr M1tail Address Cily SWte/Zip Phone <br /> Tenant A1ail Address City Slate/Zip Phone <br /> d GJ � c�2- <br /> Electrical CoNraclor Wail Address Cdy State2ip Phone <br /> State License Number Contract Price of Work <br /> j�c� �CL �,�� - - <br /> Proposed Use of Buiiding Contact F�rsnn iPlan Revie�v) <br /> Description of Work to Be Done: �a P (l,/?f}�G C���RIG}� L, f rJ f�S �}[c�P 5 � <br /> ---� <br /> RCcJI(Zc (�au..s �' . <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACF.WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 <br /> f hereby certil}�fhaf 1 have read and examined fhis applicafion and kno�v the same to be frue m�d <br /> correcL All provisions o/la�rs and ordin<vices governmg fhis(ype ol wo�k�vill be complefed <br /> whether specified herein or noL The c�ranfin�oI a pernut does naf resume fo give authority to <br /> violate or cancel the provisions ol any other stafe o�local!aw reguPting consfruchon or the <br /> pedonnance ol consVuction. Tha�1 am au(liorized.by the owne�o/this property fo Uedorm tlie <br /> work Ior which application is made and 1 cornpty wrth�he Stafe Contractors Law 18.27 RCLN and <br /> 29b.2�a WA�. ,1�� <br /> , �---- G�t � � - � � ' '� 09 (� � <br /> � Signature Dal I,�O <br /> .,` <br />