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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PE4MIT 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 /> Z Z o I �al�p,� �v2 <br /> PROJECT ADORESS <br /> Ovmer M11an AUJicss Cily Slate/Zlp Phona <br /> � <br /> Tenant hlail AAdress Gty Slate/Zip Phona <br /> �}7S.33S• <br /> Snohorn,=k. �1�.�� I►,�. `�'o do u z�g Snohcrnisl� u�k ��s�r <br /> El2drical ConlracWr Matl Atldress Cily Slate/Zip Phone <br /> Sr�oHOEz IloavJ �;���.' . '��:.' <br /> State License Number Contracl Price ol Work <br /> Proposed Use ol�udd�ng Contad Person �Plan Review) <br /> �7 n C i <br /> Descnpuon o1 Work to Be Done G C� •-1� J�J\G�, <br /> NOTE WIRING W NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE. <br /> 55. o0 <br /> CITY OF EVEREtt IOCAL SALES TAX CODE IS J105 <br /> I hem�y rerGly(Ir.d�have roaAand e�arnuied t4is applicahon and know the sama fo be frue en�- <br /> corrt>ct All piovr.ti�ons o!Imvs and ordinances��ovmning fhis fype o/work rnll be romplefed <br /> whefher spoc�6cd hwein or nof Tho gran6ng ol;�pemaf does not resume fo grvo aufhorrly�o <br /> wolafo or r.ancel uw Fnov�s�ons o�any o�he� siare or local law raguPlmg eonstn�ebon or the <br /> peAorma:ico o!construct�on. Thaf I arn aullronred by Ihe owne�o/fhis propeRy fo peAorm fhe <br /> work lor�vhah app6cation is nrade and I co;nply w�fh fhc State Con(ractors Law 18 27 RCW end <br /> 296 0 WAC <br /> Qu 5�3�o co ' �� �` <br /> nalmu D Ie <br /> `)�� <br /> ----_ _ _ .� <br />