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� <br />ELECTRICAL PERMIT APPLIC�►TION <br />CITY OF EVERETT PERMIT aERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />77a5 evER�Rr-Er� wMY � H EVeRE1T� r.JA 4320'3 <br />PROJ�CT ADDRESS <br />co..�G's ARuI,S SrezE I'�! N. Givic �, c wwur crt�eK CA 9959�0 9�5-937-1i�a <br />Owner Mail Atldress Ciry State/Zip Phone <br />enub�s �6 STe�t� 7%15 E�ER6REEN WkY £JL12ET1- wp 98203 ,ToG-415-Y7c/ <br />Tenant MailAdtlress Ciry StalefZip Phone <br />F«�SH�cRO Yb'In �1Flr�us !�L 6TE A-/Jc� {'fUK�CTEc7 tJA 9d�75 Nas-�%3—O'/3� <br />ElecVical Contracto� Mail Atltlress Ciry Siate2ip Phone <br />Fo[uSrQ483 t� I <br />State License Number <br />Proposed Use of Building <br />Descnption of Work to Be DonF: CGTv �w� ST�(Le�Tio� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />j6�5Do.av <br />Conlract Price of Work <br />Coniact Person (Plan Review) <br />l here6y certi/y thal I have read and examined this application and know the same fo be true and <br />correcf All provisions o/laws and ordinances govem�ng fhis type of work will be compfeted <br />whether specified hereir or nof. The grenfing of a perm�t does not presumo (o give authority to <br />violate or cancel fhe provisions o/ any other state or local law regulating consfruction or fhe <br />peAormance o/construction. That I am authorized by the owner o/this property fo per/orm the <br />work /or which applicafion is made and I comply wifh the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />H-��- cs <br />FEE <br />� <br />�� � �-5 3 <br />