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;. <br /> � ; <br />�:;�ri <br /> �. <br /> ;��'x., r— - -- — - <br />�� . <br /> j <br /> ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, W,4 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everethva.org <br /> .4PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> I L Z I �{I }� 5� I <br /> PROJECT ADDRESS <br /> � rVS}" l� tdcL.u7Me.t. - �fCl2. ccl .�•� S7 �v�.ia,F� t,.�- <br /> Owner Mail Address ity State2ip Phone <br /> L,� c � �sf5 w, .ti<, ,� r��sf.��+.�t r6zf y� S� ��r.�� c,� <br /> Tenant Mail Address City State/Zip Phone <br /> Y�r <br /> rrr N�c,t/ to yyoo F1�1�-1'S��,i 12� �u���,�(- G.�f- ��iLo3 776 '}(fr3S� <br /> Electrical C ntractor Mail Address Ciry S4-.te/Zi� Phone <br /> ��r,vr i :��c�� b Si. 3 ? (Oc- `'%� <br /> State Licens Number Contract Price of Work <br /> rr,��s�v�_'( _ Sf�.�� ��co..L. <br /> Proposed Use of Building Ccntact Person (Plan Review) <br /> Description ot Work to Be Done: I,v]�h�C � 2 ) S� .K (c 1,1 c�' Se<..ts C 4.S ��.�S <br /> /�.� 2K�.1i�r .. �, 7ine <br /> �� <br /> NOTE: WIRING IN NON-DWELLINGS !S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> 1 hereby certily that 1 have read and examined this application and know the sam= tc be true and <br /> correct. All provisions of law�s and ordinances govermng this type of work will be completed <br /> whether speci(ed herein or not. The grenting of a permit does not presume to give authoriry to <br /> violate or cancel the previsions of any other state or local law regulating ccnstruction or the <br /> perlcrmance of cons�rucLon. 1'hat I am authorized by the owner of this property to peAorm the <br /> wo�k for which application is made and I comply with fhe State Contrectors Law 18.27 RCW and <br /> 29ti200 WAC. I� � <br /> , ���_ �� � - <br /> Si awre Date <br />