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1 <br /> ELECTRICAL PERMIT APPL�CATION ' <br /> CIT'Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8b10 - FAX 425-257-8857 —www.everettwa.org 'i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> ti � <br /> iOL� S (o� ' e`�-�� � E <br /> PROJECT ADDRESS <br /> �tcLc.f �.� ,�c� :�^�' (cJ�%S l Gl``� S E ��'�'�=T� L J � �-t? 5 ' >�-C s - Flc�3$ <br /> Owner Mail Address Cily State2ip Phone . <br /> Tenant Mail Address Cily StatelZip Phone '�,. <br /> IJrncia,.� L�'s�77'Z .i,i-c _ �Z7.3dlkdai,,.�S ��-� �FL��`1-< W�4G�Z� <br /> ElecUical ConUactor Mail Address Ciry State/Zip ��S -�� Pho�3� II <br /> 7 <br /> �a�e �T� � �i�5 3 c c-1 CiS� _ <br /> Slate License Number Contract Price of Work <br /> S t, � �T�..� �-K�-S�iS��{38� <br /> Proposed Use o(6uilding Contact Person (Plan Review) I <br /> Description of Work lo F3e Done: ( �''�' C f-c �`� �cti 1-����f�-�-�1 <br /> 1 <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 /> 1 hereby certi/y that 1 have read and examined this applicalion and kno�v the same to be Irue and <br /> correcL All provisions ollaws and ordinances governmg this type o/werk wil!be complefed <br /> whether specdied herein or noL The granling o/a pennd does not resume fo give aufl�ority lo <br /> vialate or cancel the provisions ol any olher sfate or local law re�uPfing consfrucfion ar the <br /> peAonnance ol consVucGon. That 1 am aufhorized by the ou�ner of this property to perlonri the <br /> work/or�vhich applica(ion is made and 1 comply wifh tbe Stale Cont�actors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �,'�--.,� ��Lv � I �`�( �c> S., <br /> Signa�ure Dale <br /> CGS � l-0�/l <br /> � <br />