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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, 1NA 98201 <br />425-257-8810 - FAX 425-257-6857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.�s��l �Le1rYlOv�,tivC, ��1.f:��� <br />PROJECT ADDRESS <br />�>._��' [ � <br />�=c; �b�—tJ�S <br />��ua% � d�' 1 i ti���LL� �z�.� wet� ��c�� ii.��. �u���.�r l�J� 98�� I <br />Ownef Mail Address Cdy State'Zip Plionc <br />�tZt�S� -h'll�o�, l.�L ,, <br />TCnant Mail Adtlress Cily State/Zip Phonc <br />C� 5'U �e cC i R iC� 11��31- k0�1�� �.1.,'C f�lU� ��r' r�, � �vCl, �l 6��1 � <br />ElecUical ConlraGor Mail Address Ci1y State2ip Phone <br />��-IS��I.�CI qS�L3 <br />Statc License Number <br />�F� IC�� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: W�RING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� Il1llie W <br />Conlracl Price ( Work <br />Contad Person (Plan Review) <br />1 here6y certily that I ha� e read and exarnineAthis applicafion and know the same fo be huc and <br />correcl. All provisions ollaws and o�dinances ,qovemmg fhis type o� �vork �vill be completed <br />whefher specdied herein or noL The g�anfing ol a permd does nof reswne to give aulhorty fo <br />violafe or cancel the provisions ol any other slate or local law reguPfing wrstruction or the <br />peAoimance ol nsUuchon. That I am authorized by the owner ol this propeMy to perlorm fhe <br />K�ork lor whiclra' �licafion is ntade and I cornply with fhe Sfafe Contractors Lau� 18.27 RCW and <br />296.200 WAC. i <br />l� <br />FEE <br />� �,:3G S- C�:`5 5 <br />