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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 f�—o%Y`-'�D <br />425-257-8810 - FAX 425-257-8857 -- www.everettwa.org ���/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM //�/ <br />5 3/� F,q�,e rr�w A-�E- <br />PROJECT ADDRESS <br />/ / I'N /r1 <br />Owner <br />Tenant <br />Mail Address City <br />5��� <br />Maii Addres� City <br />��,eS> C� .�F cryaC / <br />Electrical Contraclor Mail Address <br />i�i�zstcE 97�2 � <br />State Lfcense Number <br />,�es%.�eNc� <br />Proposed Use o( Building <br />Description of Work to 6e Done: <br />: tale2lp <br />Slale2ip <br />Phone <br />Phone <br />o��S A-UE• �[/.fR.E.1T� c✓9 � 9F�2o/ <br />Cily Slale2ip Phone <br />yZs--�z� a�- ��03 <br />5'G�3 •oo <br />Contract Price of Work <br />�o�J�'i�/S <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R4CEWAYS, MC OR AC CABLE. <br />C� I'Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />read and exemined fhis applicalion and know fhe same to Ue true and <br />vws and ordinances goveming this rype o( work wi/l be completed <br />r not The c�ranGng ol a penmt does not �resurne to give authonry to <br />;ions of any other state orlecal !aw regulating construction or the <br />�n. That 1 arn authonzed by the owner ol fhis property to pedorm the <br />is ��iado a,{id 1 comply wifh the Stafe Contractors Law 18.27 RCW and <br />��ia�y/�d <br />FEE <br />