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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERM{T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FPJC 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�, I I v 1��1 vi W'J�� -1 <br />PROJECT ADDRESS <br />r�— <br />Owner <br />Tenant <br />Address <br />Mail Address <br />Cily <br />City <br />Slate2lp <br />SWte/Zip <br />Phone <br />Phone <br />�iY)c`� �Yn�r' ��Qc�� C M�t�i/1'�J tv� �%I'S�y3,�1'_`D <br />Eiectrical Conlraclor Mail Address City Stale2�p Pbone <br />C��,�D���" q���� <br />State Licenso Number <br />Proposed Use of Ouilding <br />Conlrecl Prico of Wnrk <br />Conlacl Person (Plan Review) <br />� / / <br />Description o( Work lo E3c Donc: `� "�aec %. �CK, � Wl 1� �'vUic� i�� i1u./ F� <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />DE IN RACEWAYS, A4C OR AC CABIE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily thaf 1 have read and examined this applicafion and M�ow the sa•„ � fu be trve and <br />correct. All provisinns o/laws and ordinances govemmg tlus type o/ work wdl be o�mpleted <br />whether sperf;ad herein or not The granting oI a pemuf does not resume to gi�� authonty to <br />violafe or cencel fhe �rovisiau of any ofher sfate or local law reguPting consWc6on or fhe <br />pedomiarce o/ cons,vction. Thaf 1 am authonzcd by the oa�nero/ fhis property fo peilonn fhe <br />work /or �tir�ch application is nac(� and 1 compty wrth (he Sfate Confractors Law 18.27 RCW and <br />29G.200 WAG. /,' /1 <br />� ; �� i � �� -� �' -c��, <br />Sipq Wre � , . --�_. uate <br />FEE <br />�i <br />, � � . <br />i <br />�. i � <br />