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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 — w�n�,v.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />gIG� 1��r�r'r �i� �r'r�i� iLrr 3N) Lt'r�tr�' <br />PROJECT ADDRESS <br />���fl�)/�/v� �"�l'/)I["�' /(.�/..�I <<�i'Ir�lil�l) �i�����+�,i���-l�'�� ��I�r.'/il� <br />Owner <br />Tenanl <br />, ��cPllid 1-111 <br />6failAddtess " - <br />hlail Address <br />.��.2b'l3L'Yh,�� A.�E <br />Electrical Contrar�,,r hlail Address <br />�:�er,��Er�� i�R,�� <br />State License Numher <br />C . <br />vrnrllr F���,��I�� i �ct.-r�l���ci <br />Proposed Use of Building � <br />City <br />City <br />Cily <br />Descriplion of Work to Bc Donc: _•�( (I /1 I: ).�7 t f U�(� � <br />I"li�i_ i'<�i�lr:����f� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWA�S, 'NC OR AC CABLE. <br />CITY OF EVERETT �OCAL SALES TAX CODE IS 3105 <br />u,)r� '��";���4 �1,;?5�'�35��'��f <br />Slale/Zip Phone <br />State2ip Phono <br />�i��5�' U�.����r� `1n��n <br />State/Zip Phone <br />913 ,� c%c� � � T <br />Conirect Price of Wark <br />_/�<n���i [���ci�r'� <br />Contact Person (Plan Review) <br />1 he�eby certily tlmt 1 have reaA arrd exarnined this applir,afion and know the same l0 6e frue and <br />conec(. All p�avisions o/ laws and o�dinances �overning fhis type ol wor4 �vill be comp/efed <br />whether speci6ed herein o� noL The r�ianfing o/a pennd does not presume fo give authonry fo <br />violate or cancel the provisions oI eny opie� stafe or /ocal la�v �e�ulafing consVuclion or fhe <br />pedormance ol consf�ucfion. That I am aufhoiired by fhe owner ol fhis property fo peAonn tho <br />�vork lor which applicafion is mode and I comply �tdh the Sfate Contractors Law 18.27 RCW mid <br />296 200 IM1'AC. <br />/i I �I <br />��,J.�I,.F 't i� � (f `,_l t.It_./'..t <br />FEE <br />