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ELECTRICAL PERMIT APPLICATION <br />CITl' OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APF'LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� �i ` y�- r <br />��� % r'�` ��' C���=� r�--- <br />PROJECT ADDRESS <br />� t�1 " � � � �rrr'� �� <br />Owner M Address <br />� � i( i t <br />1l� Sf�S�: ���'�'�'=-�(-�- �v���- � ��.�'�'�.�' <br />City State/Zip Phone <br />i� s! <br />Tenant Mail Address City <br />�� G`, �, ; � �C". ', �"��lC�� ``t���-:lC� t �t/ <br />��` i.�1�i� ,. <br />•Electri�tractor Mail F�ddress City <br />-'� � � <br />� - ' �� � ' �� Zs� <br />State License Nu ber <br />�� �''�' ti � � � �,� �-���-�-,- <br />Proposed Use of Building <br />i A �� <br />Description of Work to Be Done: �%� <br />NOTE: WIRING IN NON-DWELLINGf� IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />State/Zip Phone <br />,, . ��� `� `s �����;-� _ <br />'���-- U %����� <br />State/Zip Phone <br />�� ` � <br />�L4f � `" <br />' Contract Price of Work <br />r� <br />,-( ���.�C�i' ����� <br />Contact Person (Plan Review) <br />.� /�� . a-, <br />i ��L-L ._ (�,' �.� 7 <br />CITY OF EVERETT LOCAL SALES TAX C:ODE IS 3105 <br />I hereby certify that I have read and examined this applicafion 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 />whether spec�fied 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 I am auti�orized 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 />296.2 �C. <br />s I ,' ��--6_-•- _ � <br />. iz///� <br />FEE <br />���� <br />� � <br />� � �� ;�- r��-� <br />