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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV�RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIOKS ARE ACCEPTED FROM 8 AM TO 4, <br /> � I 3 c� s f/�-��,�,��p <br /> PROJECT ADDRESS \ '7`Z�`'a <br /> ;�\������� ��� � ���"�� �1���,1�� �� °I�°1s- �oa� <br /> Ownef � Maii Address City Stale2ip Fhone <br /> �— W l I <br /> Te�ant Mail Address Gty Stale/Zip Phone <br /> �W � <br /> EleCtriCal Conlraclor Mail Address Ciry Slate/Zip Phone <br /> Slate Licanse Number Contract Price of Work <br /> -hw� �u�1�x5 <br /> Proposed Use oi Building Contacl Person (Plan Review) <br /> Descriptlon of Work to Bo Done: ��'� '0�����✓ � �r�D Iv�-`�r <br /> ���(� ��-w�,D ��J�c1Z <br /> NOTE: WIRING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN Ri�CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I hereby cedify thaf 1 have read and examined this application and know fho same to ba tnro and <br /> correcf. All provisions o/laws and ordinances goveming this type of worh will be complefed <br /> whether speafied herein or not The granting ol a permit does nof presume fo give authonty to <br /> violate or cancel the provisions of any ofher sfate or I�cal law regulafing construction or fhe <br /> performance o(construction. That 1 arn authonzed by the ownero/ihls property to perform fhe <br /> work lo!which applicafion is made and 1 compty tvilh fhe Stafe Contmctors Law 18.27 RCW and <br /> 296.200 W C. � . <br /> / ,� <br /> Signat r ate <br /> E i ►�o -as3 <br />