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� <br />� <br />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 />C Soo �c- � S' s� -, �✓'� �2�-�-�- <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />��z�,�.<< � - 5 �.� � <br />Tenant Mail Address City State/Zip Phone <br />�2��� E�.�. �-n�c, lF3 t�3 �t �f3'NS� � D t2d, �Z����D w/�- R�as � <br />Electrical Contractor Mail Address City StateiZip Phone <br />4z r �, s4 3�s� <br />�L P�2,tC���rv—z7 Dc'Z <br />State License Number <br />� x c S�t r�c C�— <br />Proposed Use of Building <br />Contract Price of Work <br />M1u..e GP«� _ q2.S�4 �c(� J�4� S <br />Contact Person (Plan Review) <br />Description of Work to Be Done: l�� S�� `�. �C� fC. �.! U 1� s � N � Xc S'� i�r G— <br />�l✓G L� t� <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 />�p'�� D2�'l��- <br />FEE <br />� ��-4�.�'-- <br />I hereby certify fhaf I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a perm�t does nof presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or fhe <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 Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />� ���� � �� <br />��_____ % <br />uate <br />ClSb�~-L(�� <br />