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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42�257-8810 - FAX42�257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />acla ,aurleu �riVe <br />PROJECT ADDRESS <br />� <br />Tenent <br />Mall Atltlmss <br />Mail Address <br />Ciry <br />City <br />Slale/Zlp <br />sie�amp <br />Phona <br />Phone <br />Per�rmancc.ElecfriG �3c:�� a8�nd PI �� btank.�d 9Ba9d 3(ro-5ia�5c�9 <br />EleCirical ConVacim Mail Addreas City Slete2lp Phone <br />QE(�F(;E 19190 S <br />Stale License Number <br />}�e� i de ni-I a L <br />Proposed Use of Bwlding <br />Descnption ol Work to Be [�one <br />looc.c,u <br />��`i�� <br />� Contrad Price ol Work <br />I i� <br />Contact Person (Plan Review) <br />�ddinq a �,e�� circ��fs ,�� �a,cay c�c�ct;�;�n <br />NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAI SALES TAX CODE IS 7106 <br />I horeby ��erhly fhnf I hnvo reaA anA oKammod fhis epplicnhon nnd know fhe samo lo be fn�e und <br />corrcct All prows�ons ol/aws arrd ordinancos govomrng Ihrs fype o/ work wdl bo iromplefad <br />whefher specJred homm o� not Tho granfmg o/ n pemuf Aoes nof resume fo �rve euthonty fo <br />violato or cancol flro pmv�s�ons o! nny o(hor stafe oi local law regcPtmg consfruct�on or fhe <br />podomrnnce o/ conslructron Tlral I am aufhonzed by fhe nwner ol fhis pmparty fo pedomi fhe <br />work lor whrch nppl�cahon �s nrndo anA I comply wdh fhe Stafe Contrt+cfors Law 18 27 RCW ond <br />296 200 WAC. <br />t� �y� i i f I 5 � i D <br />