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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVEFtETT 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 /> �����- ��� �����. 4.) ��.��e� �����`� <br /> PROJECTP.UDRESS <br /> C� �� .. � C�- <br /> � � ( Z` �'�.',.}� ��J�`� ��-•c L,..i't / d�'�/l� ��J%"/h.r, <br /> Owner Mail Address City State2ip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> /// �[< �.� � 5LC qlsi�Ur. S. L ��,...t, � <br /> fliicw....�.✓� L- � 7_ � ` ��G� 3�iJ•�`�Gl(c. <br /> Eleclrical ContractOr Mail Address City State/Zip Phone <br /> � l I I %!�L-1 <br /> tate License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> / / � <br /> ; <br /> Description of Work to Be Done: / ��^% C�•-tc5f .rtc_ �%r � � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREC TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. �--� <br /> ��j ; � <br /> CI'Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certify that I have read and examined this application and know the same to 6e true and <br /> correcL All provisions o/laws and ordinances goveming this type o/work will be completed <br /> whether specified herein or noL The granting ol a permd does not presur�e to give authority to <br /> violate or cance/the provisions of any other state or loczl law regulating construc7ion or the <br /> pedcrmance of consvucnon. That I am authorized by the owner of this propeRy to peAorm the <br /> work for which application is made and I comply wifh the State Contractors Law f8.27 RCW and <br /> 296.200 WAC. <br /> ���, " / <br /> %/j%i��rf�'--- ic�/��� <br /> -' �'t S g�ature� Date <br /> �'U�-( �c� —L� � <br />