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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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 6 Svo rrti.h I� c��� Ga.r�� �,��d w.� Q�zc3 <br /> PROJECT ADDRESS <br /> Owner Mail Address City StalelZip Phone <br /> �yee At icr�J 6T?�O Iy'°H'r// ueek �cv.P., �'w� etf' Cr�A� 9�?� <br /> Tenant Mail Address Ciry Statelzip Pnone <br /> �✓wkrP�.+ ��cti Sy<k.n1' .36L3 ��f! /I�a.�/Na0 fiki�r S c,Ne f�rr�a �'�f3 Y <br /> EleCtrical Conlractor Mail Address Ciry StateJZip Phone <br /> Ij I�� �.ta�J77✓ iYoo <br /> v��•,� �/f7 �y /'n._+�5� fiF/LC�PS9tDBE l� � <br /> State License Number Contract Price of Work <br /> �/�HT /NA'IT.G/A'L ��� �� �2d��77y/9.'T�" <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: /(r�o.3r���� �ftnin f P��irrpif� ✓�'-�eGa 7�� <br /> � <br /> ��m P.,ri r�i iu !�-�'i/� �l��l+e�, c�ri%/1 ovr.+1 eYc ) <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA6LE. <br /> y3 0 000°� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this applicafion and know fhe same!o be true and E�'7�'7 � 3 <br /> conecL All provisions o/laws and ordinances goveming th�s type ol�vork will be complefed <br /> whether speci(ed herein or noL The granfing o/a pemul does notp resume to give authority to <br /> violafe or cancel the provisions of any other stafe or local law regu/ating construchon or fhe <br /> pedom�ance of conslruchon. That 1 am aufhonzed by the owner o/this propeAy to perfomi the <br /> work lor which application is made and 1 comp/y with the Sfate Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> �c/�Q.��t���G� 7�LY�Q7 <br /> ' Signaiure ���e <br />