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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - 1=AX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i �� <br /> I� �''� ��� � 5i �' lr�i�-'�� UJ. �U�'�"��.rr, �!'.!)[':��� � t,l _� �� <br /> PROJECT ADDRESS <br /> <` .iL�- �. - �.�,�,i ,, l",•e��,, r f`�"1;`�;i'�il�" 1J1� �{`�'-�TG L�LC���S3-la'a'% <br /> OWnef Mail Address Ciry Slate/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> L C i_ �,...I �;j f ��/..E ( . !l �t r- `.t ,� .�.. � i (, -� \ ��> i� � , - C � 7,r't <br /> r _1 1 ' �� �„CJ I ' � �1 �2 � /1l�I� r(/ l1 �C �/vA' 7,) �. ( �. �_��_ "C rC� <br /> Eleclrical Conlreclor Mail Address City State/Zip Phone <br /> � ,:. ,�_�� �,1 ��.��,, ;� �, _�, :Zsc.�, � <br /> State License Nwnber Contract Price of 1Nork <br /> > n�« �� 1-i� ,=i � i ; <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: (/':�' " r t!�' �` �`�� ?�'u�c'!� ��1��-�C <br /> ,VOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RA�EWAYS, MC OR AC CABLE. <br /> , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thal 1 have read and examined this application and kno�v the same to be true and <br /> cenecL All provisions ollaws and ordinances govenung lh�s type of�vork will be comp/efed <br /> whetherspeci(ied herein ornoL The granting ola pennd does not �resunie to�ive aufhordy to <br /> viola(e o�cancel fhe provisions oI any other state or local law regulating conslruction or the <br /> perlonnance o/construcUon. That 1 am aidhorized by the o�vner of Uus property to perform fhe <br /> work lor which applicafion is made and I comply with the State Contracrors Law 18.27 RCW and <br /> 296200 WAC. <br /> i j <br /> .�� �', <br /> _,�,�..:"�f-i.'' l.��L' %�/` (�G� � <br /> 5iynalure Da�l —`— <br /> I�G�U$ -Odu <br />