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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 S�p c.l_O s <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � � <br /> J� �:;; �� .��-�. ���, ��t A ��e, ��,��,� �f- �r �al = <br /> PRO IECT ADDRESS <br /> ��"�-.�7 '-la�J <br /> / �/ n i. / <br /> ;�_ ,- (,/;; � � ` ��� � l � l �z �(� i��i � �, [� i �� L� ' ' �r�� 1�1�( I'sl ���f�U�r"T�I G�la— dd�n�}— <br /> Ownc� t.1�il HdA �ss City StatelZip Phone <br /> Tenanl btail Addiess Gty StatelZip Phone <br /> `��'l�,l <br /> Eleclrical Contraclor Mail Address City StatelZip Phone <br /> Slale License Number Conirecl Price of Work <br /> .� �� r_'i !� b I L� V. � <br /> Proposed Use ol l3uilding Conlacl Person (Plan Revi�w) <br /> Descrip�ion ot Work�o l3e Uone: __ <br /> NOTF.' WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B6 IN RACEWAYS, MC OR AC CABLE. <br /> iCITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cr,Mify that!have read anAezamined fhis applicalion and kno�v the sanre to be true and <br /> correcf. All provisions ol laws and ordinances goveming this fype ol wurk�vill be conipleted <br /> whelher specdied hemin or not The�ran(ing o/a pernut does not resume fo give aufhority to <br /> violale or cancel the provisions olany other slate or local law mguPling construcben or fhe <br /> pe�lormance o/consiruction. Thaf I am aulhorized Gy Ihe owner o/fhis properfy to perform the <br /> �vork lor which applicaficn is made�nd I compry wifh Ihe State Contraclors Law 18.27 RCIN and <br /> 296.7U0 WAC. <br /> / � /, <br /> G�G�Cc2La� ,�'�+�az�-��'� �- y -0 5 <br /> SignaWre Dale <br /> �_ �i`)_�j � (i L�U <br /> , <br />