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ELECTRICAL PERMIT APPLICATION <br />i� I!D 5� <br />PROJECT ADDRESS <br />. <br />.�,� � .S � <br />Owner 'i <br />il <br />Tenant ` <br />CITY OF EVERETT 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 S AM TO 4 PM <br />Mail Address <br />Mail Address <br />C �l � � �'?� <br />Electrical Contractor � Mall Address <br />i`�,� N S L q 2� p P• <br />State License Number <br />S � c,pi aQlz-- ' <br />Propu d Use f Building <br />I � � ,n � �i. .i <br />Descriplion of Work to Be Done: <br />City <br />Clty <br />� <br />City <br />Slale2lp <br />ln � Z` �f <br />C 1f f b-d� <br />Phone <br />Phone <br />� 25 5 ��- <br />'Slale2ip Phone <br />� <br />Con��PriceofWork (206) 76 � Qso7 <br />TQS� Iu-yAO� <br />Contact Person (P an Review) <br />V�� <br />¢,�o� � �t�rn,. � • <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �'�� v'��� <br />1 hereby certify that 1 liave read and exam7ned lhis application and know the same to be true and <br />correct. All provlslons of laws and ordlnances goveming this type of work will6e completed <br />whether specifiad herein or noL The granting of a permit does nof presume to gfve authonty to <br />violafe or cancel the provls(ons of rny other state or local law regulating construction or the <br />per(ormance of construction. That I am authorized 6y Uie owner o( fhis property to perform the <br />,,,.i, i,,. �.,ti��ti no�aoa�inn !.e madn and I comvlv with the State Confrectors Law 18.27 RCW and <br />. l a�(2/� � <br />