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ad <br /> � <br /> ELECTRICAL PERMIT AP�LICATION <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 /> � � ti1� ►�t� )l�� � S ����CI} � <br /> PROJECT ADDRESS � - � O � <br /> Owner Mail Address City State2ip Phone <br /> S�a�'Q l�-D �1 �P.�� <br /> Tenant Mail Address City SWte2ip Phone <br /> �15r2�j � 3�0 <br /> �\e ��� �� \ � '�n P n� P.piC ZG3� �nC�d v� � L, �1-c� '�5�3' la�`� � <br /> Electrical Contractor Mail Address Ciry State/Zip phone <br /> � L�L�`�- °iC�2171`� � � 3Z ���a.� <br /> State License Number Contract Price of Work <br /> �hC,�i )JciV 7 �� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��lr,� �. r �� �1 ��r,•.� 1_J E�l � �, � j <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> IBE IN RACEWAYS, MC OR AC C:ABLE. <br /> CITY OF EVERETT LOCAL SALES TAX C�JDE IS 3105 <br /> I here6y ceRi(y that I have read and examined lhis application and know the same to be true and <br /> correct. All provis�ons o(laws and ordinances governing this type o(work will be completed <br /> whether speci�ed herein or noG The granting of a permd dnes not presume to give autl;onty to <br /> violate or cance/the p�ovisions y other state or local/aw regu/ating construchon or the <br /> pertormance o/con u n. at euthonzed by the owner o(this property to peiform the <br /> werk for.vhich a ic c is de an 1 comp/y with the State Contractors Law i8.27 RCW and <br /> 296.200 WAC j <br /> / /' � � <br /> �gnature D e <br /> � Gj J/ —J <br />