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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBiT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �� <br /> 'iQ (�(i f O�� �Z S "712CTj � � 1(� IJI� .. <br /> PROJECT ADDRESS L{ <br /> (� <br /> Z V�'YL�— L���» cn��: � t�y ��� ��� � �\�nr� l.�.i44 `l' � Z� 1 <br /> Owner Mail Address Ciry Slate/Zip Phone <br /> L v e•: �L'i �c?mrvw ,,�.� Ca ((c�� L v<:�ct� L-�-v'� �l 8 2, c� I � <br /> Tenanl Mail Address City SlatelZip Phone <br /> � zr-sa�-23�,� <br /> _ l� /i,��r.� e�-t t c cz�n��-t�c t�� � �v-e.u�t�i (,�-� �32,� � <br /> Eleclrical Contractor Mail Address Ciry State2ip Phone <br /> Fl2N ��z�'i �i�i� � //', 1 ;�.� � 1 � , �500 - ou <br /> State License Number Contract Price of Work <br /> r�'1 u I-1; i'��r ����s e_ ►2� e���. � Gr tx�S L��J �,s <br /> Proposed Use of Buildin9 Conlact Person (Plan Review) <br /> Description of Work lo Be Done: �n � � �O �Aw�n.A �=t,,�O 8YL '�U O N �r `�5' �Jyr <br /> �(T~'h'L �i-�tCt1- C.J� �� E F- " �lnl c O� l Z �LSA-�t� �'o�' <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. � , <br /> �lZ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS:,t05 <br /> 1 hereby certily Ihat I have read and exarnined f.'iis application and know the same fo be true and <br /> correct. All provisions ol laws and oidinances governing this fype ol�voik will be completed <br /> whelhe�spealied hercin or noL The t��anfing o/a pemut does nof resume to�ive aufhonty lo <br /> violate or cancel fhe�rovisions o/any etl�er stafe or local law reguPfing cons6uction or the <br /> pedormance ol construction. That I am aulhorized by fhe owner o/lhis property to per/unn the <br /> work Ior�vhich application is made and I comply wi(h the State Contractors Law 1827 RCW and <br /> 29G.200 WAC. <br /> �_'��:�'�-y,�;_ �-Z�-oj <br /> ,� i�nat9re �� afe <br /> i � <br /> �o'Sc7-/3v <br />