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ELECTRICAL PE�MIT APPLICATION <br />CITY OF EVERcTT PERMIT SERVI�ES <br />3200 CEDAR S?REE i, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereiiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />lS � - /�lq-�� t,✓.�% <br />�w �u;Lr��<< , <br />PROJECT ADDRESS <br />Owner <br />c✓y, <br />Tenant <br />Electrical Conlraclor <br />Mail Addross <br />� .SL,•�/J <br />Mail Addross <br />Mail Address <br />h�z�s�� �-995�^c� _ <br />Slale License Number <br />J l^!"� C-lt _ <br />Proposed Use oi Buildinc� <br />City <br />City <br />City <br />Slate/Zip <br />Stale/Zip <br />Stale/Zip <br />('i C�O C� <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Descriplion a( Work to Ba Dono: I lZ�.�i✓ l /M ��U �zMi'N T <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 />1 here6y certify that I liave read and examined this ap�licafion and kno�v the same to be frue and <br />correcL All provisions of laws and ordinances govommg fhis type o� work will be cumpleted <br />whether specified herein or not. Ihe granfinc� of a penmt dnes not presume to give aulhority to <br />violato or cancel the provlsions of any other state or local law regulafing wnatructhn or the <br />pe�fomiance of cnnstrvction. That 1 am authonzed by the owner of this property to �erfomi the <br />�vork lor which application is mado and I comply �vith Iho Slafe Confractors Law 18.2; RCW and <br />296.200 WAC. � , <br />Phone <br />Phone <br />Phone <br />FEE <br />,J��;- ���-� 9 <br />