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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 42r257-8857—www.everettwa.org <br /> :4PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 3 CREDIT CARDS RRE NOT ACCEPTED <br /> /D��'> i9�-' �� � St �#/e/ <br /> PROJECTADDRESS <br /> �10� � NiS•29e ;L.o <br /> /Z1�P�� ,G,MaqQ, Jo:i33 /��-i4t/� F-vua.�� G�� �'ZOd� <br /> Owner � MeilAddress City State2ip Phone <br /> /'I�1n,�.�Tn .l,M�,�t- �o �z-� ��N'� t�� EvU-zf�-�- z�s' ��zs-z9c-��c <br /> Tenant MailAddress City Stateri.�p Phone <br /> 1 <br /> / n /�, y2s�2,9c� - <br /> Fr G ��o�(TiC�.�.��C . l�-3t� rs�b°�c'�- �cQ. Gv�.c�t-CT� l.�%/}' q.�'l�n`7 91n[h <br /> , Electrical CONractor Mail Atldress City State2ip Phana <br /> , ra <br /> i _ - ��v?��,ti� � �2�/ <br /> � State License Number Co_n acl Price of Work <br /> c�S i�S S l jl��LvirYS Sl��� _ <br /> � Proposed Use of Builtling Contad Person (Plan Review) <br /> Description of VJork to 9e Done: �ol,J U D ( �GtC��� /�'�u,f/r�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R4CEWAYS, MC OR AC CABLE. ✓O v <br /> �3�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310b <br /> 1 hereby ceRily that!have read and examined fhis applicafion and know the same fo be 6ue and <br /> correct. All provisions o/laws and ordinances govem�ng this type ol work wi116e completed <br /> whother specified herein or naf. 7he gran�ing o/a permd does notpre sume to give euthority to <br /> violete or cancel theprovisions ol any other state or local law regulating cons7ud'an w fhe <br /> peAormance oI cons7rucYion. That I am aufhonzed by�he owner o/this property to peAonn the <br /> wo�k for which application is made and 1 comply wHh the State Contradors Law 18.27 RCW end <br /> 296.200 WAC. <br /> � �� 7�/)�h G <br />' Signatwe D <br /> �D6a�—c��`�- <br />