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i^ <br /> � <br /> i <br /> ELECTRICAL PERMIT APPLICATION <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 FRUM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPT�D <br /> �'�'o r �� f��,, �� �.� �� � t��ao <br /> PROJECT ADDRESS <br /> � cc.�,L �d � ��'��i �.� (�. �'�rr°cd 3��-�0o-0 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Atldress City State/Zip Phone <br /> (-1c�c,..�••-.a-�! �-`er_� v�� �.7rJll `ltPt��v_S �: • �n l.Ja j�pr-`YO 33�•-`t04(�, <br /> Electrical Contractor Mail Address City State!7_ip Phone <br /> � �7�1�� <br /> State License Num6er Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��� �S �U��7' <br />` NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEN�AYS, MC OR AC CABLE. � <br /> ��� • <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I <br /> 1 hereby certity that I have read and examined this applicafion and know the same fo be true and <br /> Iwnecf. Alf provisions o/laws and ordinances govemmq this type of wo�k�v.�ll be cumpleted <br /> whethe�spec;�ied herein o�noL The granting of a permd does not presume to give aufl,onty to <br /> !�iolate or cancel the provisions of any other state or local law regulating construction or the <br /> performance o(construction. 7hat I m authorized by the owner o(th�s property to peAorm the <br /> �vork'or which application is ma nd I compty with the State Contractors Lsw 18.27 RCW and <br /> 296.200 WAC. <br /> -� 9�. z ��y <br /> � � �Gnatu �ate <br /> ��c ' �l <br />