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_ � <br /> ELECTRICAL PERMIT �+►PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereriwa.org <br /> APPLICl,TIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> i ��l L L3=°� 5 ��e�� <br /> PROJECT ADDRESS <br /> wL�zzz <br /> S�Pr�2 K—/OfL / ��L�3 /�� S� F�eiE' r/ i.�A `�2�Ld 1 98'6Y <br /> Owner Mail Address City StateRip Phone <br /> Tenant Mail Address City State2l Ph n <br /> P e <br /> Elecfical Contractor Mail Address City State2lp Phone <br /> State License Num4er Contrect Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: 11/P�w SEr✓�c e �(— ie?� ��'c-.e /c,n p�, -� �d6P w�t.� r0.«-�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have read and examined this application and know the same to be hue and <br /> correct. All provisions ol laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. rhe g�anting o/a permit does not resume to give authonty to <br /> vio/ate or cance/the provisions ot any other state or local law reguPting construction or the <br /> peAormance of construction. Thaf I arn authonzed by the ownei ol this property to peAorm the <br /> work(or which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> c�..� ��'��T'/ I/ �/D �t� `-� <br /> � Signature ' Date <br /> � d�l 1 1 -tl�I <br />