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ELECTRICAL PERlVIIT APPLICATION <br />CITY OF EVER�TT PERMIT SERVIC:ES <br />3200 CEDAR STREET, EVERETf, �NA 98201 <br />425-257-3810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEP''ED FROM 8 AM TO 4 PM <br />/^�U L_ �J ��� �� �Y <br />PROJECT ADdRESS <br />Owner <br />Tenanl <br />� <br />Mail Addross <br />Mail Address <br />Cily <br />City <br />State/Zlp <br />S�ate/Zip <br />6 -� � -0'-7' <br />�DgO 6--0� D <br />S/�- � � <br />Eleclrical Conlraclor Mail Address City Statn2ip <br />/ <br />/ . D — <br />State license Number Conlracl Price of Work <br />C) <br />,%c,�.: c-t <br />Proposed Use oi Building Ccntxl Person (Plan Review) <br />Description of Work lo �e Done: <br />C4uw _!y/�P, <br />NOTE: WIRING IN NON-t�WELLiNGS IS REQUIRED TU <br />BE IN RACFWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />%v� or�7Jr� — <br />I hereb,• certily that I have read and r-xarnined this application and know the sarne to be true and <br />correct. All provisions of laws and ordinances govemmg this type o( work ivil/ be complefed <br />whefiier speci6ed herein or not The r�ranting of a permd does nof prasume fo give authority to <br />violate orcancel the provisions of any o(her sfate orlocallow regulating consfruction or fhe <br />perlomiance olconslr;;ction. rhat 1 am authonzeo by the o�rner olfh�s �roperty fo per(orm the <br />work for whi�h applicafion is rnade and 1 cornpty ivifh the State Contracfors Law 18.27 RCW and <br />2J6.e"00 WAC. <br />GI <br />Phone <br />Phone <br />Phone <br />FEE <br />� <br />,� U9Dr� -��� <br />