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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 />��j � C7 �.lTtS'� `Gi S � c7 �C.1�.� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />QaG��i-� ���11nP-�i� �'�-�I <br />Tenant Mail Address City State/Zip Phone <br />7` ft� -�-- `� 1���,� P (,�e.e i�b 6 �x I � � ��4i�� � t �,,�,,-�- `7 � �� �� ( <br />EleCtriCal Contractor � Mail Address City State/Zip Phone <br />� �v �rc c� �-� R� Z L� <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING 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 />�y,��3 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />� <br />� �� G��'.VECC'`� <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 governmg this type of work will be completed <br />whefher specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regu�ating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for,�vhich application is made and I comply with the State Contractors Law 18.27 RCW and <br />296. 200 IYVA C. <br />�-S�13 <br />FEE <br />�� <br />El3o� — O�z� <br />