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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 ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ! <br /> ;��n�� 1 ��{ , '��, Il � ,-,�. �/� ��::�t���Cc.L <br /> PROJECT ADDRESS �7 <br /> ��� (Jc^c��,( <br /> I v/�..e-( I�L'(C�11,! � <br /> a��,_ 3�5, 77c�7 <br /> Owner Mail�^,ddress City State/Dp Phone <br /> ��� ,� ���� aa - <br /> Tenah Mail Address Ciry State2ip Phone <br /> 34,c•'G:.�Z-ID6$ <br /> � �a�� 5�� �,-,,� 'j�o 73�,f 3.asy �a.-I�����,,. ���t 9�zz3 <br /> EleCtriCal Con ractor M Address City State2ip Phone <br /> �-' � i1� �� -sC c> 1Z c� � �p. oa<•�. ' <br /> State Licen e Number Contract Price of Work <br /> �'c.-�,���;-� ,�_�' ►'11 ��-cli� II l��icl�--��J— <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptionof Workto Be Dane: Q�L�G, � tr0�� 'f'U � �5 Y � ��� rt �ZC �IQ�— '+t <br /> —T <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> iBE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 31U5 <br /> 1 he�eby certify thaf!have read and examined this application and know the same fo be true and <br /> correcG All provisions of laws and ordinances govemmg this type o(work will be comp/efed <br /> �vhether specil�ed herein or not The grenting o!a permrt does not presume fo give authonty to <br /> violate or cancel ihe provis�ons o(any other state or local law regulating construction or the <br /> peAcrmance o(construchon. That!am authonzed by the owner of fhis propeRy to peAorm the <br /> �vak/or which application is made and I comp/y with the State Contractcrs Law 18.27 RCW and <br /> 296.200 WAC. <br /> �jl�, � <br /> �r�� �,Yr��9�{v ��y��s <br /> Signature Date „ <br /> I ��,,'�� - ��`�.� <br /> � <br />