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ELECTRICAL PEkMIT APPLICATIOIV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREF.T, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM'f0 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />��llS T,%;,a�l��%�r,�2�>� <br />PROJECT ADDRESS <br />�_J�_V c�(r�1� .SP_C.L <br />owner <br />��( /.� D 1 P� I <br />Tenant <br />� �lFcir�G�'T v , <br />Electrical Conhactor <br />Stale License Number <br />�C1���CS`� <br />Proposed Use of Building <br />Description o( Work to De Done: <br />€� <br />Address <br />!Ct��' <br />Mail Address <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />��i � <br />/ c;cy <br />Ciry <br />t20 % <br />City <br />�. <br />e-}� lc,��a `� �} 7�, <br />Stale/Zip <br />State/Zip <br />•�rn Gc�i� � 9�a33 /&n� <br />State/Zip <br />� v I O- . �( J <br />Conlract Prico of Work <br />r9� <br />Conlacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES T� X CODE IS 3705 <br />1 hereby certi(y (hat ! have read and examined fhis applicalion and know fhe same to be true and <br />correcL All provisions o/ latvs and orclinances �overnm� fhis fype o/ �vork will 6e coniplefed <br />whether speabed F.erein or not The granfing ol a pernut does not resume to give aufhonty to <br />violate or cancel fhe provisions ol any ofher sfafe or local law reguPting construction or the <br />peAonnance ol consirucfion. That 1 am aufhorized by fhe owner ol thrs property lo perfonn the <br />work lor which applicafion is made and I comply wifh the Stafe Contracfors Law 1827 RCW .and <br />256.200 WAC. <br />FEE <br />E O5d5- c�� <br />r�«r; �� y <br />Phone <br />Phone <br />GS`I <br />Phone <br />