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ELECTaICAL PEr�MIT APPLICATION <br />CITY �F EVERE7T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T & CREDIT CARDS ARE NOT ACCEPTED <br />SPR�NT' K��sK 1401 S� FdEReiT r`�AtL rJY�UERETT� W✓4 98ao0� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Cily <br />Stale2ip <br />Pnone <br />5T('I�JT�R�ialD SFbiCIC %NJ1 SE EVERE'� MhLL W`( EVER�1'�—� WA 94��� y1S-3S.3'Coz� <br />Tenanl MailAtldress Gty Stale/Zip Phone <br />FoC�LSM-4icRJ HGYO �Ar`��5 t�( -`+rF A-1� !�'�UICi�TEe� WA 9d'.27.5 y�s�93-oY3s <br />ElectricalContractor MailAddress City StatelZip Phone <br />�o��sMz 48� 4 I <br />State License Number <br />Proposed Use of Building <br />Description of Work to 8e Done: ''GGAR ALqR�t ?�ClCriGE <br />NOTE: Vt9RING 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 />'f �H88 Dc� <br />Contract Price o� Work <br />Contact Person (Plan Review) <br />I hereby certi(y thaf I have read and examined Ihis applicaGon and kncw the same to be true and <br />conecf. A/l prnvisions oflaws and ordinances govemmg this type ol work will be. comp/eted <br />whethQr specdied herein or noL The granting of a permd does nofp resume to give authonty to <br />violate or cancel fhe provisions of any ofher state or local lsw regulating construchon or the <br />peAormance ol construchon. That I am authonzed by the owner of this property to pedorm the <br />work /or u�hich applicalion is made and 1 comply wdh the State Contracfors Law 18.27 RCW and <br />296200 WAC. <br />OS <br />FEE <br />