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�� ;,+ <br /> f — — _ <br /> ELECTRICAL PERMIT APPLICATIO(� <br /> CITY OF EVERETT PERfI�iIT SERVICES �I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�,w,nv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE �IOT ACCEPTED <br /> I _� 1 0 `I ��� S-� SE Lo•,— 3 0 <br /> PROJECT ADDRESS <br /> � i � � <br />� R - . ���,� �� ._._�� <br /> � Owner —� <br /> i Mail Pddress City Slate!Zip Phone <br /> I <br /> I Tenant Mail P.ddress Cily StateiZip /' \ Phone <br /> r� l�G Z�I <br /> YVaJ�h M,\�et E�1GL�r ;� `��IZ`� 5(�tnn«�Cir nr F��e.�ne�_ (17. `l��v5 33(. -,S7Z <br /> Electrical Contractor Mail Address Ciry SWIe2ip Phone <br /> �L'J„'� i1�t'_.`t�i 1 N '� <br /> State License Number Contract Price of Work <br /> Proposetl Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: Te,i„�P Qa (P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R4CEWAYS, MC OR P.0 CABLE. <br /> I <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> (he�eby certily that I have�ead and examined this application and know the same fo be true a�d <br /> correct. All provisions of/aws and ordinances governing this type o(work wifl 6e completed <br /> whether specified nerein or not The granting of a permd does not pr2sume to give aulhonty to <br /> violate or cancel fhe orovisions ol any other state or loca/law regulating construcfion or the <br /> per�ormance ol construction. That 1 am authorized by the owner of this propeRy to pe�form the <br /> wak!or which applicatior,is made and I camp/y with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ���,�f�L-�.� � � �' ' ° `� <br /> , <br /> Sig wre paie I <br /> E ��fG � -E71 () I <br /> i I <br /> -- -- - - - �- �� <br />