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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8357 —�niww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ������ ��n �J/' , i�J , �� c,`�t� L��"��,�-- <br /> PROJECT ADDRESS <br /> �,f�`9`— � � ��k1�Z`� `<h�, �.Ja �/$�`zo �6`�-lccrn <br /> Owner Mail Address City Slate/Zip Phone <br /> _� <br /> Tenant Mail Address City State/Zip Phone <br /> �� �l �- � f`�l( �t�� . 5 .�'. <br /> «<.��..c�.. « ��� � Q �a�-« LJ � l$✓�'a �3n -9alE <br /> Electrical Conlractor Mail Address City State/Zip Phone � <br /> l 7`t�rt T I <br /> State License Number Contrect Pnce of Work <br /> Proposed Use of Building Contact Perscn (Plan Review) <br /> Description of Work to Be Done: ���—��`��-� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN FACELVAYS, MC OR AC CABLE. ry,.•� <br /> �� ' ` <br /> ICITY OF FVERETT LOCAL SALES TAX COOE IS 3105 <br />� I hereby certi(y that!have read and examined this application and know the same to be true and <br /> cc�rect. All provisions of laws and o�dinances govemmg this type o(:vork will6e completed <br /> I �vF,ether specihed herein or noL The granting o/a perrrut does not piesume to give authority to <br /> violate or cance/the provisions of any other state or local law r_�gulating construc6on or the <br /> peAormance o/constructi n. Thaf I am authonzed by the o�vnei o�this property to perform the <br /> work tor which applicati is made and I comply wifh the S!ate �cn;racto�s Law 18.27 RCW and <br /> 296.200 W,4C.. / <br /> l�� �� % �� <br /> ��-� G G% <br /> namre p�� <br /> i <br /> , l ;' � �U�� � � _ �S 3i <br />