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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />q aa -o �{ <br />C� 4�i -o�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT $ CREDIT CARDS ARE NOT ACCEPTED <br />�/Z�' K<<l•� A�e_ <br />PROJECT ADDRESS <br />Sn (. .. n-, 1371 cql.-- Lq,,,.l /ZLv�� L.-q L��1 c.��( C�( C <br />Owner Mail Address City tate/Zip Phone <br />S-i�i � S v i. l( S �� / 7_ �5 !� ,.�- /r �: A•,�— <br />Tenant Mail Address Ciy Stale2ip Phone <br />., � <br />Electrical <br />'1 � c /1.� i,/: <br />Ma8 Aadress <br />—/�� i /v,V� c ��S /- 3 <br />Stale Licens Number <br />`�1<,. � <br />Praposed Use of Building <br />).v �l� %vc.c���i' 4�- l�Zo3 <br />Ciry <br />Stale/Zip <br />P �00 Un <br />ConUact Pnce of Work <br />y cs- <br />�7L sS83s— <br />Phone <br />5-/�,.�_ />t�,,.t /� <br />Contact Person (Flan Review) <br />Description a( Work to Oe Donc: i N�, / 9 r� ("�� �; { ,( � q ��f„� _� L�/-{�. � <br />r <br />�� (�� IHn��./v <br />NOTE: 4VIRING IN NON-D�VELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE la 3105 <br />I hereby cer7dv thaf I have read and exammed this applicaticn and know the same fo be true and <br />correct. All prewswns of laws and ordrnances govemmg this fype eI work �vdl be completed <br />�vr,ether specd�ed herein or nct. The granLng o7 a perm�t does n„t presume to gne authority to <br />violate er cancel the provis�ons ol any ether state cr local law regula6ng construction or ffie <br />peAormance o/ construcbon. That 1 am authonred bv fhe o�vner of this property to perform the <br />�verk !or which application is made and 1 comply �vrtti ;he Slate Contraclers Law 79.27 RCW ana <br />296.200 WAC. <br />FEE <br />v� -� j <br />