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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 — v✓nnv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5'��:�3 `�c-�,c�9w�� <br />PROJECT ADDRESS <br />� hA�ies t 1��beq 'Tho�-�` Pc S�ox �sa7 c�<,��� e✓a `frSaa� _ <br />OwnCr Mail Addmss Cily Slale/Zip Phone <br />{.�r� <br />fen2nl <br />Mail Addmss <br />ti <br />City <br />Slate2ip <br />Phene <br />L 11S`4"M P�s,��.. ,.i�,�.. ��t k�..4� kys4. b�i�ti.,�,, ��n- s�zzs ��o�-a- <br />Elecincal Conlraclor Mail AAdress City State/Zip Phone <br />� ^ '1,(CIf hS0 �l.J <br />Slate License Number <br />Proposed Use of E3uilding <br />Conlract Price of Work <br />�C n �N r) r> > / <br />Contacl Person (Plan Revie�v) <br />Description of Work to Be Done: �° -� "ru i�/.'is �' "`' <br />� <br />� • <br />�h�itritilt�N __� ��l,�.r.[n4�f r ��' �-[/ti/�%tc ��t <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED 70 <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hcreby certify that I have r�ad and examined fhis applicafion and know the sarne to be frue and <br />rorrecL A71 prowsions of /aws and ordinances govemmg ihis type ol work will be completed <br />whether speci/ied herein or not Tbe granling oI a pennd does not resume fa give aufhonty to <br />violale or cancel the provisions o/ any ofher sfale or local law reguPting consfruc6on or fhe <br />peiformance oJ cons6uc6on. That 1 arn authorized by the owner o�this property to perform the <br />work l�rtivhicf+application is made and 1 comply wifh the State Conlractors Law 18.27 RCW and <br />.'GL �_--�-T-a.,,ti '-� �D <br />cJ� �—c� � <br />