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ELECTRICAL 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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�` ����, <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />�.,�o l ��,-f'� j Z�Z- �S%:��n. <br />Mail Address <br />U � '� �l <br />Mail Address <br />�YU 1��,� �i G, �, i�-,f � f� � <br />Electrical Co�ltractor <br />Address <br />� � � �L� <br />State License� mber <br />F <br />��� U^��� � <br />Proposed Use of Building <br />Description of Work to Be G3one: (/ {i �� <br />m <br />��j- �r.�-�--� �� <br />City State/Zip <br />/{' K /j' <br />City �Z�,,�at�i� <br />�!���� � � � <br />City <br />Q,� C�y�- �' <br />/ i� <br />State/Zip <br />�!�� <br />Contract Price of Work <br />. � ��� <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. �� <br />Sc� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing fhis type of work will be completed <br />whether specified herein or not. The granting of a permit does notp resume to give authority to r <br />violate or cancel the provisions of any other stafe or local law regulating construction or the �- �?J- � Z—� 3�� <br />performance of construction. That I am authorized by the owner of this property to perform the �-- <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296. 200/O�VAC. <br />/ iT 1 c <br />Phone <br />Phone <br />Phone <br />