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ELECTRICAL PERMIT AF�PLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S g_��_� y <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —v�n+.lv.everettwa.org �o yb��63 <br /> APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> (P�'� ' 6{,t�(��� CR��:<< �Fr�K�v,9-�f , �ui�e roG <br /> PROJECT ADORESS <br /> O�vner Mail Address Ciry State/Zip Phone <br /> � l <br /> �'J�(n.t,'L <br /> Tenant Maii Address City State/Zip Phone <br /> �Z'� <br /> �rE�u�NS 4�����,�a te�G,o�,�s �3oc:� �/.E. z��'� sT. �G�r,.e G✓l� 9b'�ns- �s�-3�� <br /> Elechical Contractor M11ail Address .Ciry r �\ State2ip Phone <br /> �r // i ��� 1 � //j' <br /> J j // <br /> `�!E bbtE P�� I+D K o �s o-� . �-� <br /> State License Number Contract�of lNork <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �escription of Work to Be Done: �� �Ol`�-�,Q, +}"��55 ��"�C� �� 7��r.'2' ��z`(�S <br />� <br /> NOTE: WIRING IN NON-DWELLI�ivS iS !�EQUIRED TO FEE <br /> BE IN RACEINAYS, MC OR�G �ABL�. <br /> I CITY OF EVERETT LOCAL SALES TAX CCOE IS 3105 <br /> 1 here6vi ceRily that 1 have read and��:xamined lhis application and kno�v the same to be true and <br /> correct. All provisions o(laws and ordinances governing this iype o(werk will be completed <br /> � �vnether specr6ed herein or not. The granting ol a permd dces not presume to give authonry to <br /> � �oolate or cancel the pmvisions of any oMer state or local law regulating censtruction or the <br /> peAormance o/construcGcn. That I am authonzed by the owner o/this properfy fo perlorm fhe <br /> .vork lor�vhich applicallon is made and I comp/y with the State Contraciors Law 98.27 RC W and <br /> � 296.200 WAC. <br /> I ' /� �� � <br /> ;�,�c�'_,,,..,,� ���,,t;. .-r, �; <br /> iSic,nawre �./ . '' �at= <br /> � <br /> �d��8'�� <br />