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,.: y <br /> , <br /> , <br /> c�:.n — — — I <br /> ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES , <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 —w�.vw.everettwa.org <br /> APPLICATIONS AR� ACCEPTED FROM 8 AM TO 4 PM - DEBIT & C�EDIT CARDS ARE NGT ACCEPTED <br /> �,- <br />::';;�= ;` �'C. -�/'� :H S�, J�.C . <br /> PROJECT ADDRESS <br /> C £ � <br /> Owne� Mail Address City State/Zip Phone I <br /> :.'w{w�:. Tenant Mail Address Cily State/Zip Phyne <br /> (3 U <br />�,�Y;� 4 J <br /> N����. , / �/� <br /> � . l�Fvi.�- /i"/�«C-i= `� 5cT2.c �1S'Z� SPr./.rit,.« �cn.-/� �v,v 9i9-y:��' <br /> �.',a ElectricalContraCtor MailAddress City StalelZip ���/�' Phone i <br /> h <br />, �� .�-,,�,,� 9��,,✓y <br />�` �" �.,,' State License Number Contract Price of Work <br /> �,C�' ..: `" �� <br /> /�—L—$.O�.fT//d C ��.��' <br /> Proposed Use of Building �� Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: �"T�'-'E f-�r'^�' ����^'P ��vv�cE -}- <br /> �� ' <br /> /�st ,� �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRify that I have read and examined this application and know the same to be true and <br /> correcf. All provisicns o/laws and ordinances goveming fhis rype o/work will be completed <br /> whethe�specibed herein or not The granfing of a permd does not presume to give authonty to <br /> violate or cancel the provisions o/ary other state or local law�egulating construction or the <br /> perormance of construchon. That I am authorized by the o��ner of this property to pedorm the <br /> work lor wnich applicaticn is made and 1 comply with the State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � ,� <br /> _ _ ��r�/'.•�f'`� ,, l�z� . � y <br />� S�gnature Date <br />� I I <br />, , , ,�//— / U�— I <br /> � <br />