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ELECTRICAL PERMIT APPLICATION <br />CfTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8&10 - FAX 425-257-8857 — wv,nv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SOI�i Co LB `l IaU� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Addre55 <br />Mail Address <br />Gty <br />City <br />State/Zip <br />SWte2ip <br />8 —7 --� <br />�OgD�-a <br />� L' <br />Phone <br />Phone <br />-l�/��� <br />EleclricalContractor MailAddress City Slate/Zip Phone <br />Slate License Number <br />�,,QS r?�c2 r�LG e <br />Proposed Use ot Buiiding <br />Description o( Work lo Be Done: <br />�L <br />GaFG�' o� <br />NOTE: WIRING IN NON-D�"/ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contracl Price of Work <br />Conlact Person (Plan Review) <br />! l,nr�by certily fhal I have read and examined fhis opplication and knou- fhe same fo be hue and <br />�orrecl. All provisions ollaws anAordinances goveming fhis fype ol worYc will be completed <br />whe'i�e� spealied herein or noL The c�ranting ol a pemtd ooes not pmsume to give aulhonty to <br />violafe or cancel the provisions ol any ofher sfate or loca! law regu/afing cons(rucfion or fhe <br />pedunnance o/ construct�on. l�haf 1 am aufhorired by fhe owner oI fhis propeRy ro peAorm !he <br />work Ior which applicafion is made and 1 cornply wi(h fhe State Confractors Law 18.27 RCW and <br />�ar. �nn uin� <br />FEE <br />� �10�'i -��,:�f � <br />