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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRCET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org �_a5-Uj <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> L O�J4 ' _(3Z <br /> g l�o E !�l I}R I�(��[I�-_cn1 p�1�(E <br /> PROJECT ADDRESS <br /> 1�IG�G����w�,n �t �ve•��.�+ '�o,(�0�[4�`� S�i�ul����. ���- ��2`ll- o�F33 <br /> Ownef Mail Address City State2ip Phone <br /> ��+...._.R_ <br /> Tenanl Mail Address City StatelZip Phone <br /> ��� M �=���v;c. 7.�fl� P�N� _r-���n��- �u� � �z5 Z-�4�"7 <br /> EleclriCal Contractor Mail i,Cdress City Slate/Zip Phone <br /> r f�l= /�y / � l�lli�"' <br /> State License Number /�� I U Contract Price of Work <br /> S I �I�/ <br /> Pmposed Use of Building Contacl Person (Plan Review) <br /> Description o(Work to Be Done: _�I�� l4�+�� �PV�( � �`ti�tii� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRily thaf I have read and examined this application and know the same to be true and <br /> cc.�rect. All prov�sions ol/aws and ordinances goveming this type of work�vilf be completed <br /> whether specilied herein or not The granting ol a permd does not presume to give aufhonry to <br /> violate or cancel the provisions ol any other state or local law regu/ating construction or the <br /> pe�formance o/construction. Tha!1 am authorized by the o�vner o(this property to pedorm the <br /> �vork(or�vhich application is made ano 1 compty wifh the State Contractors Law 18.27 RCW and <br /> 296200 WAC. � / <br /> �����t�n�_ Z - Z 5'l� S� / �� (/ <br /> SignaWr �ate ,�ti/ � <br /> /1 Y. <br /> Cr��l/ <br /> J <br />