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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.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS PRE NOT ACCEPTED <br /> (,�0 3 `� /� t� �'� S f�, L o i :�2� <br /> PROJECT ADDRESS <br /> � <br /> Q. s D >��k cc� tk <br /> Owner Mail Address City State/Zip Phone <br /> i <br />� � � " Tenant Mail Atldress City State2ip Phone <br /> �, � � I <br /> tl � ,{ j ; Njev :..� ��.��cr F\cc y�iZ�j Sj� �i.�nc��e: Qr Fru.-lnnd U.�.,_ ';N: Y9 36.7331.7� Z <br /> I. L+ .,. <br />��.�;,,`''��;�. I Electrical Conlractor Maii Address City State2ip Phone � <br /> i.-�Y�i_ . 1 <br /> � 1Zc�,...�..C•;� �N �-I <br /> Stale License Number Coniract Price of Work <br /> I <br /> Proposed Use of Building Contact?erson (Plan Review) � <br /> Description of Work ta Be Done: T.• �� �c �P I <br /> . �t _ <br /> C.:;';, ; <br />� � �, <br /> �t�.� <br /> � <br />�` �� ��' <br />! ?��,+/���+� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> '�{ BE IN RACEWAYS, MC OR AC CABLE. <br /> '! ?`'�.I, <br /> � ,rNi � <br /> . ��'::;i;i� �t <br /> s� � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 I here6y ceRi(y that I have read and examined this application and know the same to be true and �` <br /> correct. All provisions ollaws and ordinances govermng this type ol work will be completed �, <br /> �vhether specdied herein or not. The granting o/a permd does not presume to give authonty to <br /> ��iolate cr cancel the provisions of any other state a local law regulating construcLon or the � <br /> pedormance of construct�on. Thaf I am authonzed by the owner o/this properiy to per/orm the j <br /> work for whicn application is made and!compty with the State Contraciors Law 18.27 RCW and i <br /> 296.200 WAC. <br /> ___________������ // / G'L� c•.�, S r G �-/ i <br /> � <br /> Sig amre p�e �� <br /> r; <br /> i <br /> � I <br /> . . �" . � �"�'�r'l 9 <br />. I.,, ,i — --� -- -- —.. � <br /> i <br /> L�:'._ —._— —"'f��" -- . — �. _��__—___' <br />