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ELECTRICAL PERNlIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERL•TT, WA y8201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> '-i'�Z3 1/cs��t� U�s�,r �� <br /> PROJECT ADDRESS <br /> R5+-IoI� �E}�DY `i82-3 v��c� ,��. �+-� � � - � � �a �izs- i��f � vr:.�� <br /> Owner MailAddmss City ete2ip Phone <br /> Tenant Mnil Addross City Slele/Zp Phone <br /> B��CK- S�6Et"' GLEGZLG �/�Ci C �o�. N�D Fib'"� -sr �J �.r�t»�J-.o��wn `r9�iL> ,J�(� `�3Z Z4b$ <br /> EleclriCalConlradof MailAddrass City� SIale2ip Phone <br /> I � ) <br /> ��.�c���, ; Q G ( I� r�l � ��F4f�0 �70 <br /> State Licensa Numbor � Coniract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Doscription of Work to Be Done: „1�.-rL-�f�(`r �Tt1� r,a -. rc:i�r«b �•t'f�!� ,_.� ���J�.�. <br /> NOTE: WIRING IN NON-OWELLINGS IS RE�:JIRED TO FEE <br /> BE IN RACEINAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LGCAL SALES TAX CODE:S 3705 <br /> 1 hereby certity tha11 hav;, �ead and examined Ihis application��nd know fho sama to be L.�e and <br /> co/rect. All prnvisions ollaws and ordinances govemrng fhis�ype ol work will bo complofed <br /> whether spoafied hemia or not The granting ol a permR dres no(presumo fo give authonty to <br /> violate or cancel fho provisions ol any othor stafo or local law rogulafing construcfion or fhe <br /> peAormanco o(constr�r.��on. Thot I am authonzed by tho owner ol fhis property to perlorm fho <br /> work Ior which applicafion is made and 1 comply with fho Sfats Contractors Law 7927 RCW and <br /> :96.200 W�C. <br /> 7 G� ZF�G� <br /> Sig ature Da1e <br /> �C3�CG7—OQC� <br />