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ELECTRICAL PERPJIIT APPLICATION <br /> CITY OF EVERETT PERMIF SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �� ��� I 1 � ��' ( ����1�� ` '� ��� <br /> PROJLCT ADDRESS <br /> Gwner Mail Address City State2ip Phone <br /> �,J� il_s i n���h�� .;���c� , �,� ch Jv�.� r�c ftt,t ,_�,�, �t-f-- <br /> Tenant Mail Address City State2ip Phone <br /> p: <br /> 1 �_ ',{ ��J I <br /> �vE�1 �—\t�` 1L `f�14`� �v\ il7l,� �ty� !l�� f —� ✓1v`��-t�1Dl�. %���rl-�i ''�'f <br /> Eleclrical Conlractor Mail Address City StalelZip Phone <br /> r Q <br /> ���a�rti ca- I ���' '/���o � ' J <br /> State License Number Contract Price of Work <br /> ��� ,� k .��! :c�c�. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptian af Work lo Be Done: ��.��.9�1 �1 � l ��t1I (��1�- , � I�y,�1 ,$: .'�`I�c �'<'J , .� ''�5�� I( <br /> i ' <br /> � � 1C y "��'D-��E' � �Oi` ! c��SCfv.� �rc, li� � ►�� D�� e �� CG.v\ (�GLI.�'f <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined this application and know the same to be true and <br /> correct. All previsions o/laws and ordinances goveming this type of work will be completed <br /> whefher specified herein or not. 'fhe granting of a permrt does not presume to give autl�onry to <br /> violate or cancel fhe provisions o/any other state or local/aw regulating construction or the <br /> peAormance o�consfruction. That/am authonzed by the owner o/this property to periorm the <br /> work lor which applicatien is made anC I compty with the State Contraciors Law 18.27 RCW and <br /> 295200 WAC. <br /> Jc <br /> �� � <br /> , <br /> SignaWre Date <br /> -' , /� <br />