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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-II810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `';C_.���� VV� -� f :,iuc � 1'�c�.r.c. �:a.c, . -1�- .," <br /> PROJECT ADDRESS <br /> �� � <br /> If+.. 1).. �1.,i: ,. ."�. `=�? lr_n 'i ��i'i 'l�C.��.t ���= `j :11i,•1 ' c:�cil <br /> OWnef 1.1a�lAtldress City Sla�eldp Phone <br /> / <br /> Il��r: 1�..i`.t^!l ��i. <br /> Tenant tAatl Address City State?ip Phone <br /> �-�.-��� Zr�Cv��.ini.�._ �:�t:lni:_ c�--1C1.- fJ�.� jf�:' ��z, i1- � li -.-r-t-i�c � l�`�t '�C i17 i'�5-�i�7-r�l ti, <br /> EIBCtriCalContraCtor 1,1ailAddress City Stale�Zip Phone <br /> � � �� 14� <br /> F,�{i.�`,_c��_� _�� � l��i/ <br /> State License Numtar Cont•act Price of Work <br /> Proposea Use of Bwld:ng Contact Person (P,an Review) <br /> Description of Work to Be Done- �� .-,�. � - .^Jc .� ��� � ,, �. F,._,��c�u�_� F�o�+N-, � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN R.4CEWAYS, MC OR AC CABLE , ��:' <br /> C� I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310F <br /> I haeby certdy thaf I have iead and ocarnmed th�s appbcahon an0 kno�v fhe samo tu be true and <br /> conect. All provisions olla�;s and ord�nances govern�ng th�s type al n�ork��;dl be completed <br /> nlie(hor specdied he�ein or not The 9ranting o/a permd does notp res�mie fo giva authority tc <br /> vicla(e or cancel the prov�sions o/any otlier state or local law regulafmg construcfion or the <br /> pedonnanco ol conshuction. That 1 am authonzed by(he owner ol this property to perfomi fhe <br /> �:ork lor which applica(ion is made and I comply with the Sfafe Contrac(ors La�r 18 27 RCW and <br /> 296 200 WAC. <br /> � <br /> �� � '/ -%I'1���' <br /> —�T naWre� � Da�e ��� � <br /> � --� - �,$l, j <br /> 1 <br />