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� <br /> 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 1 — 'Y�"� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � � : . <br /> PROJECT ADDRESS <br /> (� �`o_ ��' <br /> nv y� J � ��v�� �,.,-e,- q �y �c��6X /�Soc `� %�e����r.1 /��c� � <br /> , T <br /> Owner � Mail Atldress � / Ciry Slate2ip Phone <br /> � dz5 Yv�� 3 e ) <br /> Tenant Mail Address City StalelZip Phone <br /> � <br /> � (�' ` <br /> � f��b �cJ��—c� C1�-�c��F j, s ,���� �f- <br /> EIeCU�� .. .;ontractor Mail Address � City StatelZip Phone <br /> /�U C�C-^= % S/— D� .3 l� l7 ���C�4 pc <br /> State License Number Contract Price of Work <br /> �J�S �( ,��-�c" � �.�( `y`r cu�'—" . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Wark to Be Done: /��"" r i � � � '` )"� / 2 � �L �/G //� �, ✓���1��[�f �c��� <br /> }:<�, �-y�.� .,��,�l --I-� :c-� C� �, � }_�c c vC� . ..! C•-6 F}�. 1 I`'e� c�li���<2 7�. s,��.. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRi(y that I have read and examined this application and know the same to be true and <br /> correct. All provisions o//a�vs and ordinances govemmg this type of werk will be comp/eted <br /> whether speciGed herein or noL 7'he granting af a permrt dces not presume io give authonry to <br /> v�olate or cance/the provisions of any other state or local/aw regu/ating construction or the <br /> pedormance o/construchon. That 1 am a orized by the owner o(th�s propeRy to peAorm fhe <br /> �verk lor which applicaF n is ma G an c mply�vifh the State Contractors Law f 8.27 RCW and <br /> 296.ZOO WAC. <br /> ,' .% - !���C 7 z 7/°`� <br /> Signatur¢/ Date (' <br /> � L��{Ci'� -IZ 7 <br />