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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.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARGS ARE NOT ACCEPTED <br /> � � �' % W/' 'T i-t c' �.'_ 7'r <br /> PROJECT ADDRESS <br /> �-�-'t-'-7' ,['j�� 2 �c9 tva �,,,;�.z ,at, /' v,�•c�Tt !u� �P�d�-, �1��i-3�4�' -U�7 <br /> Owner Mail Address Ciry State2ip Phone <br /> �' U(r� <br /> l- r.=F /c-v / ,rT,l(� ti ,��= /�-ni>T�r.a_-.�f u�A- 9Fiai G Z2�-5F2Z <br /> Tenant Mail Address Ciry Stale/Zip Phone <br /> 3C•f�-4�GF-^ 47 ; <br /> F'!'I C s �'-r_t?.c j 3�/ iE�,��T sE_T �5�/Oh-G�=7i�/r , c.iiG�,>�.-���v' 9.a�s%r: <br /> ElecMcal Conlractor Mait Address City State2lp Phone <br /> .E'/�/C �s E ��I�C•� <br /> State License Number Contract Price of Work <br /> c�v��.,�.ri� r�i—� <br /> Proposed Use of Buildin9 Contact Person (Plan Review) <br /> i <br /> �escription of Work ro Be Done: /�l `% i C '�� "- �� !i- .�- � / G� rr-TJ�`�-C-'- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �j�r� <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined fhis application and kno�v fhe same to be true and <br /> correcL A/l provisions of�aws and ordinances govermng this type o/work will be ccmpleted <br /> whether spealied herein or nct The granting o�a permd does not presume to give authonty to <br /> violate or cancel fhe provisions of any other state or local la�v regu(ating construction or the <br /> pedormance of ccnsfructwn. That 1 am aufhonzed by the owner oI(his property to peAorm the <br /> work lur whir,h application is made and I comply�vith the State Contractors Law 18.27 RCW and <br /> 296.200 W.QC. <br /> / <br /> F� /,' ��,__� /—'�''G�U!� <br /> �� Date <br /> �- �/Z /-�� <br />