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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SE�VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �y0 � �S� �/1 (t� E(�/In_�'j' <br /> PROJECT ADDRESS <br /> /�Olc� C_/Y,9��'.9N� S�/oS /s> �i � Cae/�crl' G�a° ��y2a/ <br /> Owner MailAddress Ciry SWle2ip Phone <br /> Tenant Mail Address City Slate/Zlp Phone <br /> (e�o�'�,o �iE���,�� i�y�a ���-���w� 2 Gyti.���� �.�� 9��� uzsasa sP <br /> , <br /> Electrical Contractor Mail Address Ciry SWle2ip Phone <br /> I.�rx�nF�S �a��G 7� 7�� G� � <br /> State License Number Contract Price of Work <br /> !�Y C' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �lJ / G/zCnlT. c/ auT/•Td � G�S,GiS � /1C/y,b/O <br /> � <br /> �✓;iLa �1(X�i!'1 <br /> i <br /> NOTE: 1NIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE ItJ RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I hereby certily that I have read and examined this application and know the same to be true and <br /> correc7. AI!provisions o(laws and ordinances goveming this type ol work wil!be completed <br /> whether specified herein or noL The granting oI a permit does not presume fo givc authonty to <br /> violate or cancel the provisions ol any other state or loc:,l law regulating construction or the <br /> peAorrpar�ce ol construcnon. That/am authonzed by the owner o(this property to pedorm the <br /> workfor ti ich application is made and I comp/y with fhe State Confractors Law 18.27 RCW and <br /> 296�100 C. /) <br /> � �7'"(�./.'�✓'� /3 � /% " �C'G��� <br /> �8fgnamre Date <br /> Eo�il�-oy5 <br />