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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 d AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � gOC� <f/=T .�%���T <br /> PROJECT ADDRESS <br /> �-i=,c�i.z��ti' �'O,�,r /�'io�3 G1/�o/r%�� f'✓F,u,;�CJi� yb�G �9� 5�9� ��s�%. <br /> Owner Mail Address Ciry State2ip Phone <br /> (/F_,e/2o/✓ /�a' `f/'r �'L`� <br /> Tenant Mail Address City Stale/Zip Phone <br /> L.�N/TF� E.�'�i�.�� Co.ui���7vrZsltiG. .S3u� 5�.��� ��-. '`',1.:�� EdE��.�oi.;9157�.3��f,t�2�1•98// <br /> T <br /> Electrical Conlractor Mail Address Ciry State/Zip Phone <br /> G1�tJiT�'<<ci7�r..�-� '�/7�00 — <br /> State License Number Contrect Price of Work <br /> �L-C/�� <br /> Proposed Use o(Building Contacl Pers�n (Plan Review) <br /> /� i �� <br /> Description of Work ta Be Done: �/.@c��y,CA/fC7 �� ��CR�� /V02%iy <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC C�BLE. <br /> � ���//� 7 — <br /> � � / <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I he�eby certify that I have read and examined this application and kno�v the same fo be true and <br /> correcf. .411 provisions o//aws and ordinances govemiag fhis type o/werk will be compleled '� <br /> whether speci6ed herein or not. The granting ola permd does not presume to give authunty to <br /> violate or cancel the provisions of any other state or local law regulatMg construction or fne <br /> peAormance o/construction. That 1 am autho�ized by the ownerol this propeRy to peAorm the <br /> work)or which applicafion is made and I comply�vifh the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. �j <br /> —S f' �'% /`'ti'' y/ h���:;'. <br /> Signatul,r" �' �ale ' / <br /> '"� /� � �c'-� <br /> .� <br />