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0 <br />ELECTRICAL PERMIT' APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, b'VA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�- ���> <br />�;`-i�"�1=fl �� ���ree.� �,J �,� — <br />PROJECT ADDRFSS <br />Owner <br />' i I <br />Tenant <br />�n���� <br />Electrical .ur racic <br />Mail Address <br />�-�e�s� A�ti1�,- <br />Mail A�idress <br />J <br />Cr.iCF?CSL�I2'zLC�j <br />Stale License Number <br />Proposed Use of Buildinc� <br />Descriplion of Work lo Bc Done: <br />PAail Address <br />�12a� ��� <br />�� `� t` <br />� x�ti.�s <br />rh b.ul��wl �tL <br />�- J <br />NOTE: V�IRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RAC�WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />���Y <br />City <br />Slale/Zip <br />s�,«izr <br />Slatc/Zip <br />Phone <br />P�,om� <br />7ZS-7SY— <br />Phcne <br />�!�i<�(cY / c ��c, <br />�. � C� �.� <br />Conlract Price of Work <br />�icl� i�f�G� <br />Contact Person (Plan Review) <br />1 heieby ce�iily thaf 1 have read and ezamined fhis application and kno�r fhe same to be frue and <br />correct All provisions o/ laws and oiclinances c�o� aming this type of �vork uill be completed <br />whefher specdied herein or not The grt�nting o( a pernut does not presume fo �ive aufhonty to <br />violate or cancel the provisions olany ofher sfafr cr local law regulating construchon or fhe <br />performance ol construcfion. That 1 arn authorized b}� the owner olthis property to perform the <br />�vork for rvhich application is made and I comply with fhe Sfafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />7' <br />FEE <br />�-�"i U� - 0 5 3 <br />