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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 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> / �� � � /��� V�, S -�Z, <br /> PROJECT ADDRESS <br /> t�V �� �l- cN Di��' �O 121�X IoJ�I S,cC/l,d�„sl, U�/1 9oZ`�/ <br /> Owne� Mail Address City Slale2ip Phone <br /> �UA. S�7h�'���o <br /> Tenant Mail Address City State/Zip Phone <br /> A LL 51�cIZU�C� �c:/n(C- ��ZGS`�� ��'y Suo►,�n�s6 � ��� Zod-3�9�/a/ <br /> Electrical Contiactor Mail Addre s Ciry State/Zip Phone <br /> /� �-�-S�i('L.� �25 C-N /lDOU c�o <br /> State License Number Contract Price of Work <br /> O �j—l G�'=y. �n-G�� T✓2-C�1��"� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 7 <br /> Description of Work to Be Done: � fr�-i�J/�-7cil `J �t L !� G� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certity that I have read and examined this application and know the same to be true and <br /> correct. All provisions of/aws and ordinances governing th�s type o/work will be comp/eted <br /> whether specilied herein cr noL rhe granting ol a permit does not presume to give authonty to <br /> vio/ate or cancel the provisions of any other state or/ocal law regulating construction or the <br /> peAormance of construchon. That 1 am authonzed by the owner of this property to pedorm the <br /> work/or which application is made and 1 comp/y with fhe State Cont�actors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,�� � ��— l2-�� � �f <br /> � Signatu`A Date <br /> I <br /> ` <br /> �oti i a-�3F� <br />