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ELECTRICAL PERMIT APPLICATION <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 ARt ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> / oS" 3 � lr �� A � �. <br /> PROJECT ADDRESS <br /> r. o�r ��cf� �er � 7���8 f� ST S� �c�[y./"� <br /> Owner fdail Address City State/Zip Phone <br /> CASc•�..V� PI� zA lvs � � % 9 �=� .�1�� .��= £v�.�fa <br /> Tn,nant Mail Address City Stale/Zip Phoae <br /> �_n� � r�.,� �� 7Ynr, //:�.1.��.✓ /1J �vrrc./-� (-vf� Yrs= 77G- S�f13S_. <br /> Electrical ontractor Mail Atldmss City State2ip Phone <br /> � rvNcr. �.S�L3 � /oo. c,v <br /> 6,,. . <br /> State License umber Contract Price of Work <br /> S l v� l�l c. L, <br /> Proposed Use of Building Contact Person (Plan eview) <br /> Description of Work to Be Oone: i v L[ �/ � , <br /> S �. . l. S, ... <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 />� I here6y certi(y that I have read and examined(his application and know the same to be true and <br /> correcl. Al/provisions of/aws and adinances goveming this type of work will be comp/eted <br /> whether speci6ed he�ein or not The granting o(a permit does not presume to give authonty to <br /> violate or cancel the provisions of any ofher stale or local law regulating construction or the <br /> pe�formance of construct�on. That I am authorized by the owner of this property to perform the ��I I <br /> work for which applicatica is made and 1 comply svith the State Contractors Law 18.27 RCW and <br /> 290.200 WAC. <br /> / i � <br /> r <br /> J�� �/� __' I �� . <br /> / I \ <br /> • iatu e Date / v <br /> f� <br />