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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 ACGEPTED FROM 8 AM TO 4 PM <br />___�_�� ��- ���� �� � �� � l i � l"L.�� �?i , �r� ��� � <br />PROJECT ADDRESS /3b � � -� �� <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />�� <br />State/Zip <br />Phone <br />Phone <br />GC�C.� � ��• � �-C �l C� �'t� � C � LL �/�l�l ii/ /��L� �'V'�� y(y�. �� /r%S � i ��3 �r7 � <br />Electrical Contractor Maii Address City State/Zip Phone <br />< C; c: c� SSC �f .� � i� �^ <br />State License Number <br />�,.-,��1�.. ���.-..1� �W�11,.��-, <br />ProposecrUse of Building <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: /�'yK��Z ri��l Ci!'� S��^!' ���•fj � j`��r3< j,,,� ,:, /�� <br />"� /�n i -+P <br />/� �//.�/ e / / �„ /_ n n <br />I'1<'(�/ S��L'«-Z �l(+77'1-[I /Lo'�-G' !.G/�l�it' /��7T� L c � 7C�J/i ��LG�C/C <br />� ,� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CObE IS 3105 <br />I hereby cerfify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governin� fhis fype of work wil! be completed <br />whefher specified herern or not. The granting of a permrt does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construcfion or the <br />performance of construction. That 1 am authorized by the owner of this property to perform fhe <br />work for which app�lication is made and 1 comply wrth the State Contractors Law 18.27 RCW and <br />296.200 WAC. � I % <br />i��-/��-`, f <br />FEE <br />� � � �.�3 <br />�� <br />