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:„ <br /> Js - �. _z � <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32C0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-E910 - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEC FI�OM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> �J��/ i /1��,-�;� � (/, � �ti� _L'r, � <br /> PROJECT ADDRESS <br /> �_ ��y , �L / qC9z��v) <br /> �•�17�.ar �i Y✓e/P // �p .3�9 San �I�� �,�� /vP,c���]�nc/, �f-t 9y9-76D-600Z <br /> Owner Mail Address City State.2ip Phone <br /> Fxxe � l�ac �'c ,�2 � %c'�r�,��,i�� R� 1���;,�� ... VII�'.��IKZtG�3C�- 73y.c�'7.� <br /> Tenanl Mail Atldress Ci State2ip Phone <br /> �g73za) <br /> s���� �s EIP� i���� �as�s� 4� �-��� �'�, r,�l ss'��.���-3��� <br /> Electrical ContraClOr Mail Address �\ City State2ip Phone <br /> ^C" �1 ,�y � .. <br /> �Y <br /> tSU�iISEF 0 ',��l ''� ' ' � ���� - <br /> Siate License Number �! Contract Price of Wor� <br /> � /] � �[il'i�9, / Cc✓PL� C�i1 � <br /> �c'�7�0/ C'rp --T <br /> Proposed Use of Bui ding Contact Person (Plan Review) <br /> Desr,ription of Work to Be Done: {C'(, /� �C i1�f: /0 ���✓ /G/� <br /> i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. '-� <br /> 3S � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I her�6y cerfify that I have read and exammed this applicatien and;;n;�v!he same to be true and <br /> correct AI!prowsicns ol iaws and oidinances 9overnmg this type ol�vork�vdl be completed <br /> �vhether specdied here�n or not. The granting of a permd aces ncr ores:�me to grve authority to <br /> violate or cancel tne provisions o(any other state or local law regulating construction or the <br /> periormance o(construction. That 1 am authunzed by the owner ot thrs propertp to perform the <br /> �vcrk/or which application is made and 1 camply�vdh the Stare Contractors Law 18.2?F2CW and <br /> 296.200 �YAC. <br /> �S CCl 5`t�� � S �.ZS- �' % <br /> Slmawre �ate <br /> � ��., � � � ( � 5 <br />