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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERV'ICES <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 <br /> _j I �) Z �1'l I"�-1 �'V � <br /> PROJECT ADDRESS <br /> Owner tdail Address City State2ip Phone <br /> � � t � SS'c�znn�t, f��c�5 �vrrzr- �� w�i `1 £Czc>._ <br /> Tenant Mail Address City State2ip Phonc <br /> �fJ 5 - �f 3- S'i57 <br /> t+�L�F�(� �qnm�" LATtu�a� �^s° N�, IlVicey � (�ivf�LS�uF P�C. i3or��e�� wA �FiC�j __ __ <br /> EleC�rical Contraclor ldail Address Cily Stale2ip Phone <br /> � <br /> )=�il� ii=C�_ GbZDZ �FS�Z�`= <br /> State License Number Conlract Price of Work <br /> ." �w�MZJ ��Dc�Z Z[�4� � 371-lill� <br /> 1`�i-�t �� <br /> Proposed Usc of Buildin� Conlact Person (Plan Roview) <br /> Descriplion of Work lo�e Done: �I���(.� �Nn �� ���'r-�^'�i �-�L`� <br /> NOTE: WIRING IN NON-�WELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA�LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31J5 <br /> 1 heiehy certi/v fhat 1 have reod nnd en�amined fhis application and kno�v fhe seme to Ge frue onA <br /> corn:cL All pinvisrons olla�+�s and orYiinances goveming this fype ol work�vil/be cornp/eted <br /> n�hether specdied herein or noL The c�ranting of a pernut does nof presume to give aulhonty fo <br /> violate or cancel the pro�-isions of an��olher sfafe or local lo�r regulsfing conshuction or the <br /> pe�fo�mance ol const�uction. Thaf 1 arn aufhonzed b��the owner o/fhis property fo pedonn fhe <br /> ivork/or o�hich applicafion is mode and I comply wifh fhe S(ate Confractors Law 1 B.D RCW and <br /> 29G200 IM1'AC. <br /> . _�i" <br /> - -'r�,�. � ( %c�. .�..__ � �iy�� � <br /> l_5i{�nalwe ` Dae <br /> L� �i��.'�-i i�� <br />