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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVE�ETT PERMIT SERVICES <br /> 3200 rEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 U - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - '?EBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> _� �y � `�� � / � ���"U,=� .S� _ 'i� �1�� <br /> PROJECT ADDRESS <br /> � Gy <br /> 1-�����'��I ll.i �r1 `�i ��( ii�;L�/, I C����;K /C•.�`� ,=s{c�jii'/l SEI, GL��� J U��f� <br /> Owner Mail Address City State/Zip Phone <br /> `�(�S� i � i>i}� , <br /> Tenant Mail Address City State2ip Phone <br /> �-1L� �,rz.i-'UiCu� i�Lr•zi'i i�ic- / uGG� �/��lG� Cv� `��C�llc;iifl� l'✓/� ��2�G ZGG'��J�/G� / <br /> � <br /> Electrical Contractor Mail Address � City State/Zip Phone <br /> C;G U <br /> n � ���: ,, �i= l%: >-c r� C:ic� <br /> State License Number Conlract Price of Work <br /> �=��.��v-1 � L ����}C�l`�- � 'u 2c�11 ��� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> , <br /> Descriplion of Work to Be Done: / ti`� ��� �' �`�� ��f ti� `i y' `_>�, �'-V i t :�_ �� Tk'c r ; r��%� ( <br /> cc, , <br /> � c V,Z.G, l C� /�/1�lI C <_ e;,;,. ;;c=iFC' ii. , .�f \ [�;� /Ghjz� <br /> — : — <br /> MOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEINAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALF.S TAX CODE IS 3105 <br /> I hereby ceRi(y that I have read and examined this application and know the same fo be t�ue and <br /> correcL All provisirns ollaws and ordinances govemmg this type o(work will be completed <br /> whether speci(ied herein or not. The granting of a permd does nof presume to give amhority to <br /> violate or cance/the provisions ef any othe�state or/ocal�aw regulating conshvction or the <br /> peAormance of construction. That I am aulhorized by the �wner of ihis property to perform the <br /> �vo�k ior which application is made and I comply with the �tate Contractors Law 18.27 RCW and <br /> 296.200 INAC. <br /> �\ <br /> ,� ��',?l � - <br /> �� c� <br /> _ _i! _ %��,�-- � L' .% / -G �=� <br /> � � Signature � Oaie <br /> I <br /> �� ld - ��' . <br />