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�LECTRICAL PERMI�' APPLICATION <br /> CIT'� OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APP'_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARUS ARE NOT ACCEPTED <br /> � c�.� o �a Ke u � � �1 r <br /> PROJECT ADDRESS <br /> �v�c,� t�r �-t, i �.�p S 5 � 4� S l �f 0� 0+�_lV �. =�d°� <br /> Owner J Mail Address City State/Zip Phone <br /> l�»'L F tll� 1". C,tJ�- el POf�.� <br /> Tenant N,a�l Address City State/zip Phone <br /> �'�r Pc�z�i LL�GT2� � �r �q fi �� ; �'�� i�-�r /� o►�R �r�� g��g <br /> Fle trical ContraCtor Mail Address - ' � City State/Zip Phcne <br /> �� ;�/��/1����� > <br /> State License Number �-- � - � Ccntract Price of Work <br /> �— <br /> Proposed Use of Building Contact Person (Plan Review) <br /> I Description of�york to Be Done: � /Q /2� s�/- �/ �'�� f,I'(� <br /> �,�f i��iY�� �E��G�_ O,A/ '�` � o;� OQ r"' � ��t/�celEt!' <br /> �� /� S � t�� <br /> � <br /> NOTE: WIRIN3 IN NON-Dtib'ELLINGS IS REQUIRED TO FEE <br /> BE IN FACEWAYS, MC OR AC CABLE. <br /> iCITY OF EVERETf LOCAL SALES TAX CODE IS 3105 � <br /> � I hereby certily fhat I have read and examined this application and know lhe same to be true and <br /> I ' conecf. All provisicns rn`laws and ordinances governmg lhis type o/work will be comp/eted <br /> whefher specified herein nr nct. The granting of a permit does not presume to give authority to <br /> v;olate or cancel the provisions of any ofher state orlocallaw regulating construction or the <br /> performance ol consVuchon. That I am au:horized by the owner o(this property to peAorm the <br /> �verk/or which application is,made and I comply wifh the State Contrac!ors Law 18.27 RCW and <br /> 296.20G WAC. <br /> /�� � <br /> �:^` �=-.�• ,, . r--c.� /�. /�. ��Y <br /> Si - r0 Date <br /> �./ <br /> � 0�{t2.-lo( <br />