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r <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 9�g...�g <br />3200 CEDAR STREET, EVERETT, WA 98201 C! <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ��g0 9`d S� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />L� 3�3 �u�, �,�py �uz� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail <br />Mail Address <br />Contraclor Mail Address <br />��'Y1.�4 3U 5S ��FZ�� <br />Slate License Number <br />Proposed Use of Building <br />Desr,riplion of Work to Be Done: �� ,� <br />NOTE: W'RING IN NON-DWELLINGS IS REQUIRED TO <br />SE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />Ciry <br />City <br />Stale2ip <br />Slate/Zip <br />State2ip <br />Contrect Price o( Work <br />Contact Person (Plan Review) <br />1 hereb}� ceriily that 1 have read and examined this application and knrnv the same to be true and <br />correcL All provisions o(laws and ordinances goveming this type oI work will be completed <br />whefher speahed herein or noL The granfing of a perm�f does nof presume to give aufhonty to <br />violafe or cancel fhe provisions o( any olher stafe or local law regulafing construchon or the <br />peAonnance o(consfruction. That I am aufhorized by the owner o/this property to perform the <br />work /or which applicalion is made and 1 comply with the Stafe Confractors Law 18.27 RCW and <br />296.20A WAC. <br />0 % /�S lo�' <br />FEE <br />� vi <br />F c� s-���. o S� <br />Phone <br />Phone <br />