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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV�RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> <?�� ;1 - <br /> � . , , �� �i,i' ��/- <br /> PROJECT ADDRESS <br /> � <br /> i�, _2 , J� � �r�� `�I// -� "�l/,'„ - �jl_ f�����YI /.i iY-� -+c� -- y <br /> �JaSJ it '� _ SnC <br /> Owner A1ail Address Cit�� State/Zip Phone <br /> Tenant Mail Addross City Stale/Zip Phone <br /> �C� 1= SPdw� �_ �C1' I;� . �7H !,".,L...�) �ti�� �Y.>yc, y�.�-.���%r - 7�„=�' <br /> Eleclrical CpnlraCtOr Mail Address Gly Slale/Zip Phone <br /> _ < <br /> ti i� �"i r, rV' <br /> Slate Licmise NumL�r Conlracl Price of Work <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Description vl Work to De Done: Fl,/�;�� ,�C-C�- ,�,-.r ' � •.� .� �, <br /> � NOT[: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�iily Ifwf I have reaA and examined fhis applicalion and know fhe sarne fo be true and � <br /> conecL A!1 prorisions oI laws and ordinances govemrng this fype oi work a�ill be complefed <br /> ��1 Z - �"� ' <br /> whefher spealieA herein or noL The granfing o/a pemuf does nof rnsume to gire authenty to <br /> violate or cancel the �rcvisions ol an}�other stafe or local lan�r�guPting construcfion urthe <br /> peilom�ance o/cons�rucrion. Thaf 1 am aufhunzed b}�the ov,rier ol fhis property to pednnn fho <br /> work!or�vhich application is ntade and I cofnpl}��vilh the State Confracfors Law 1827 RCW and <br /> 296.200 11'AC.- i „ — <br /> j i `-/ <br /> _ �' � � <br /> ; i � � �"� �� - f�' _ Q �. <br /> � Sionalw� Date <br />