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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREcT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 415-257-0857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> S% S .� . <br /> � v� - , ��b�-�-�- <br /> P OJECT A DRESS \ <br /> ��l-jf`J `_>� /.J��N/�C S/�'. . <br /> /U�/Z /5�0 iv/�' ' _ , < < w ��'ZOF,' <br /> O�vner Mail�dress Cdy State2ip Phone <br /> C� ���Z /��i ,� <br /> Tonant Mail Address City StalMZip Phone <br /> �n�rs L� c���r��G ¢zs- ���'- slG6 <br /> ,, v�h .vc. /G 4Yv6 5'0�'�� ��, . /cr�c�h-r�ti�r� �.A. q�o�� <br /> Eleclrical Contracic. M tl Atldress City State/Zip Phone <br /> �l�/�S �/�l l���' ff l ,2�7�d) �j 7/C�� C�cJ <br /> State License Number / Contract Price of Work <br /> �s/�vc �=� rc /�[�vriNs��f�r xr <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��rLU �/? �L 2 / c x�S�/�/��j�Z i:.��i <br /> ��/� �<_f l T S f-�,��� �J /��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE lu 3105 <br /> I hereby certily that!have read and examined this application�nd kno�v fhe same fo be We and <br /> correct. All prowsions ol laws and ordinances goveming this type o!werk ivill be comple(ed <br /> whefher specilied hemin or ncL The granfing ol a permd Aoes not presume to give aufhority to <br /> welate or cancel the provisions of any other state or Iecal la�v regulating constiv.:tion or the <br /> pe�ormance o;consrrucfion. That 1 am authrnzed by(he owner of ihis proper,y to peAorm the <br /> wcrk lcr�rhich applicatien is made and I ccmply wdh the Stafe Confrac(ors Law ]8.2i RCW and � <br /> 296.200 WAC. _� / ( / I� <br /> //�'�,�.�%��t • U ( , �I <br /> S�gnalLre Oate l/ <br />