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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 425-257-8i357 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />'; � J� � L;v � S� ��-E�T <br />G�r ER�� � W � '�F�:�O-S <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State/Zip <br />Phone <br />P�.�>c�caFs� P�����sr r� �� EvC'���-r :�� �'e:�U� -�:��;- �'�°i � 3� �� <br />Tenant Mail Address City State2ip Phone <br />Electrical Contractor Maii Address <br />Ac.��v c� �C' �<��rf S��`'� — <br />State License Number <br />Proposed Use of Buiiding <br />City <br />StatelZip <br />� Ll �Jo O <br />Contract Price of Work <br />Contact Person (Plan Review) <br />, <br />Description of Work to Be Done: � CJ ;�%h.1— � JW ��( 01�� CJ� � v��`--�- � ��� � <br />� <br />� C��'�.� �` <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 />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing th�s type of work will be completed <br />whether speafied herein or not. The granting of a perm�t does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That / am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 Wi4C. <br />FEE <br />�� <br />/ <br />�ll� ._.� �� i� _ j ��,. <br />Phone <br />