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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 —wvwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> _ i f� i 4� G A s�NO R�J <br /> PROJECT ADDRESS <br /> RC��(�t= CONS� UL1�OI / <br /> Owner Mail Address Ciry Slate2lp Phone <br /> Tenant Mail Atldress City Slate2lp Phone <br /> �( � lJ�n//V �� ��/�//� <br /> Electdcal Contractor Mail Address � Cily Stale2lp Phone <br /> /�(C L� /lV,C C 0 0 3 �V�?' <br /> State License Number Contract Price ol Work <br /> SF/� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ���� ^1.f�Gl/ ��/� <br /> �oo HMp U (� <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �S S, od <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby ceRdy that I have�ead and eramined this applicaGon and know the same fo be true end <br /> w�ether spePilied herem or nof.ndhe granf/ng ol a aermit doea notp resume�fo glve a P(honfy fo <br /> violate or cancel the provisions ol eny other state or local law reguleting construction or the <br /> wo�k lorawh ch appl cation�s made and I comply w th�he State Contra�cfors Law�8.2 RCW end <br /> 296.200 WAC. <br /> _�%� ' �.��:�� / - /3 - 0 5' <br /> �y,� ���e /� �/ _� Date <br /> � <br /> �d5G1-o5Z <br />