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- . <br /> ELECTRICAL PLRMIT APPLICATION <br /> CITY OF EVERETT i'ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857--www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEP.IT & CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> i� <br /> ���..7 z <br /> � L1 ��\ I ` 1 Ae�f �� i� 1� - l0 \ <br /> PROJECT ADDRESS <br /> ,�L;��- \ � ,��(� �i ! ` o,i ��� f �� I?i�,x ICl �`l �n��lic.�,� . L. `j'`dZr'� � <br /> Owner Mz�iTqddr�^ Ciry StatelZip Phone <br /> c' I <br /> � U.��`'� � � � v� r� �c�vn '�c:. S �bC�i .-4 <br /> Tenan: Mail Address City State/Zip Phone <br /> c l p -7 <br /> � � c �.�:�t�. 1 r � �� � 'G '��x Zo i`3 �1�n�'1C>n�. � <� �.. � l'i` I�� C��, � <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> � I e c� ��- �C C� °� l�-z_ iu N I.Y�� `���: <br /> State License Number Con act Price of Work, <br /> _ G�'lf ,� \ )ra'`, � �; <br /> Froposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ����c� � n o <' .� �� c�; �-� ��( �I ; •�_{' � <br /> NOTE: WIRING IN NON-DWEL!INGS 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 here6y certify that 1 have read and examined this application and know the same!o be true and <br /> correcL All provisions ollaws and or:linances govemmg th�s rype o(work will be completed <br /> whether specined herein or not The yranting of a permd does not presume to give authonty to <br /> violate or cancel the provision of any other stale er local law regulatrng construchon or the <br /> peAormance of constru ��hat I�fn authonzed by the owner of this properYy to peAorm the <br /> wcrk for which app� �on s made�and ly with the State Contractors Law 18.27 RCW and <br /> 296200 WAC. ,% � ���A�� <br /> i �% <br /> � - ' ,'/ / - �/�7��1/ <br /> � Signawre �— Date ��j <br /> // i <br /> ,-�� <br /> � <br />