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ELECTRlCAL 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 �0-7(�3-U� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �C%� � �L�C_ l�'�/` � C%� CG'G�2c/I, GU�2', ��',�D 1 <br /> PROJECT ADDRESS <br /> �y,�s>-�Jy � <br /> �ocrS 7�' �eo 1 �s`ty,J�e SEr.�,���5 � c�3�`l l2u�k Q,� ,qa,.e , sf��°° c"vT, (v/�. FB�v� <br /> Ovmet Mail Atltlress City State'Zip P�cne <br /> � <br /> . Q IL, C_ <br /> Tenant M11ail Atldress City Slate�Zip Phone <br /> .5��. � <br /> �/�/i�r �Cc�cfR��� �,2�7 '-,'�i�`,�c. �fs1�.�uk,Jf�o. c�.; �'�;z7s� <br /> Elec ical Conlractor Maii Address Ciry State/Zip Phone <br /> � �yo� --- <br /> �i��F� � � � �� x ,� _ <br /> Stale License Number Contract Price o(Work <br /> �'/ T/C: C <br /> Proposed Use o(Buildiny Contact Person (Plan Review) <br /> Description oi Work to �e Done: _ ��1� S%(�� ��/.2 �u / � }�� S/l.�p m�� '✓"44 � <br />� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQIJIRED TO FrE <br /> BE IN RACEWAI'S, MC OR AC CABI.E. <br /> �I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I1 hereby certily fhat!have read and examined fhis applicafion and kno�v the same to be true and �V 10'��t'L,U, <br /> correct All provisions ol laws and ordinances governmg lhis lype of work wil!be completed <br /> �.vhether specilied herein or noC rhe�ran6ng of a permd does not presume to give authonty to <br /> vrolafe or cancel the provisions ol any olher state or local!aw regulating consiruction or the <br /> pcAor onstruct�on. 7hat 1 am aufhor d by the owner o(ihis property 10 perlom�ihe <br /> �v or�vhiGi a icafion is made ana I co fy wrth the State Confracfors Law 7827 RCW and <br /> 25G 200 WAC. <br /> � / �— � <br /> � � � -'J � 3 a�— <br /> �� _�_ � <br /> � Signalure Da;e <br /> I <br /> Y <br />