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ELECTRICAL PERMIT APPLICATION <br /> CITY (�F EVERETT PERMIT SERVICES �..a6-0 s <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -w��wv.everettwa.org C d����ad <br /> ' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE N�T ACCEPTED <br /> �70 .� �v.c rG.-��n (t i � �/ r <br /> PROJECT ADDRESS � <br /> '1�r��� <br /> OWner Mail Address City State/Zip Phone <br /> �: ' 1� C�� �l <br /> Tenant Mail Address City Stale2ip Phone <br /> �-t� /" tl-� �N.r . .r��r,� cL/CF�•iC /77 �i /" <�/IVCift•C'I l�,� %�r'/i�RyfG�'I , 1//t //LT3 'JLC"'��l`��! i <br /> Electrical Contractor Mail Address City � State2(p Phone <br /> AJe �:��-r. �.-1� �/ I�yI�D �`( 2p� cJ <br /> State License Number Contract Price of Work <br /> �iIrIJRil. rCr �l�r.Cy.V'i (C 1 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> +u.y / <br /> Description of Work to B� Done: ��. ��,r� � / fv r �/:,. �. /i r ��` A �1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC AR AC CABLE. <br /> CITY OF EVERE'fT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify thar I have read and examined fhis application and know the same to be true and <br /> correct. All provisions ollaws and ordinances goveming this rype o(work will be completed �'�j U\-�Z O <br /> wnether specified herein or not. The granting of a permrt does not presume to give authonty to <br /> vio/ate nr cance/fhe provisions ol any other state or local law regulating construction or the <br /> pedormance o(consfruction. That/am aufhorized by the owner of th�s propeRy to perform the <br /> work for which application is made and 1 comp y with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ; <br /> ,� <br /> �i� <br /> �/�``� �/�� �—�/..-6' J— <br /> ' ignaWre r = Date <br />