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ELECTRICAL PERMIT ApPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-885% — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />JZ��, �VP���f'NC�.bI �'L�4�' <br />PROJECT ADDRESS <br />Owner A9ail Address <br />�� I ��� _ <br />Tenant Mail Address <br />%l,A7aGt 33�A �-u4<<��n��`I- i3�.�,.� <br />Electrical Contractor h1ail Address <br />./�u>Gk' L.�of�;l T <br />Slale License Number <br />Proposed Use of Building <br />Descriplion of Work to Be Done: ���_LO](� <br />City <br />Gity <br />City <br />� <br />State/Zip <br />State'Zip <br />-� L,Ooo <br />Contract Price of Work <br />Phone <br />Phone <br />-g0a331` <br />Phone <br />Contacl Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />EE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily that I have read and examined this application and know fhe same to be true and <br />cor�ecL All p�ovisions o(laws and ordinances poverning fhis type o( work will be cornpleted <br />whether specilred herein or nof. ihe �ranlinc� ol a permil dces not resume to give authonty to ry <br />violale or cancel Ih� provisions ol any ofher sfate or locel law reguPting construcbon or the 6l� <br />per/o�mance o/ construc6on. That 1 am authonzed by Ihe owner oRhis property fo peAorm fhe /� � <br />work lor �vhich application is made and I comply wilh the State Contracfors Law 18.27 RCW ano �/' 1 <br />296.200 WAC. <br />� <br />�� � <br />c}�� <br />