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ELECTRiCAL PEF?MIT APPLICATlnN <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 & CREDIT CARDS ARE NOT ACCEPTED <br /> S L �i- �� (� 4� 5'� � l' �u'�- � `� <br /> PROJ[CT ADDRESS <br /> � `' Q ���i � C! e-�-�c <br /> Owner Atail:,Cdress City State/Zip Phone <br /> Tenant Mail Atldrees Ciry State/Zip Phone <br /> CGa> <br /> ev�'n E��;Ile� �le_� 45z4 SA�nn�.lrzr 1�. �reeln.�J ��. 9�zv�r •33 � � �s�� Z <br /> Electrical Contractor Mail Address City State2ip Phone <br /> LL U � Y1 A.�Z�I �I I N f.( <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriptian of Work to 8e Done: � �:ti.(� � ( p <br /> I <br /> NOTE: WIRING IN NON-UWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7?LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify'h I have read and examined fhis application and know the same to be Uue and <br /> conecL Al;prov�. ns of laws and ordinances governmg this rype o/work will be completad <br /> �,vnefher specilied herein or noL The granting of a permrt does not presume ro give authonty to <br /> violate or cance/(he pro�isions oi any other state crlocallaw regulating construc6on or the <br /> peAormance o!construchon. That I am authorized by the owner of this propaRy fo perform htie <br /> work lor which applicatinn rs made and I cemp(y�vith the State Contractors Law 18.2i RC W and <br /> 296.200 WAC. <br /> � <br /> � —'�'-- � 5 �, � � <br /> �ignature Date <br /> i " <br /> _ _ — � � <br /> ; 7`ti <br />