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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820' <br /> 425-257-8810 - FAX 425-257-8857 —www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � -�(J o /k e�r�c;li L,�<< l� 1:�,�,��,, A-u <br /> PROJECT ADDRESS � <br /> I�AS �+„��a.,; ,�o c��.� <br /> Owne� M il ACdress City State.2ip Phcne <br /> ATS <br /> Tenant Mail Address City State/Zip Phone <br /> As,���,';a-� � ���� �F.�r �a ,s��� ��� .5,4,4��,;,c. t,�J,� �8,�r� /��� 3sr-�s,� <br /> Electrical COnlreclor Mail Address City State2ip Phone <br /> ✓�fi s, �c �c -o �'f�N� t4' /6.S J � > % <br /> State License Number Contract Pnce o Work <br /> L' �1"i'-�.�_ /LJ- � � r'�TiJ4�1. <br /> Proposed Use of uildin Contact Person (Plan Review) <br /> Description cf lh'ork to Be Done: W .� JL��..) � �I�-t C'` �T�� �� <br /> � — F <br /> � <br /> � <br /> ' I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRify that 1 have read and examined tBis application and knou�the same to be We and <br /> correct All provisions o(laws and ordinances govemin,q fhis type o/�r�ork will be completed <br /> whether specihed nerein or noL The granting of a permd does not presume to give authority to <br /> violate or cancel the provisions o/any other state er Iecal law regulating construcnon or the <br /> peAormance of construction. That I am authonzed by the owner of this propeny to peAorm the <br /> I �vork!or which application is made and I comply wdh the State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> I , % , <br /> � /'/' , '' ��/��,/�- <br /> � � -��,,..� <br /> '�, Sianawre D te��- � <br /> � � I �I � <br /> / <br />