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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIGES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />G-� ? 3 f'�n, ,� <br />PROJECT ADDRESS <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />S',f, C t�r.�e.e�-i c�%- 9 0�3 <br />�/� ,��{�k' � /� �/!�� � "ti4 �� EU�R c��`!' � 98.1v 3 ��10 � h3 <br />nc G .�/ %��2i <br />Ownef Mail Addros, City State/Zip Phone <br />Tenant <br />� -1,�- i'1 ��/ <br />Electrical Conlracror <br />Slate Licease Number <br />Propased Use of Building <br />Mail Address <br />Mail Address <br />Cily <br />City <br />State2ip <br />State2ip <br />Contracl Price of Work <br />Cordacl Person (Plan Review) <br />Phone <br />Phone <br />Description of Work to 6e Done: Lv� S��, �!/1-�.2� /J �ry �) .r �..'0 23 �f�./1.C..f i'c� N <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 hereby cerfify fhat 1 have read and examined this application and know Ihe same to be frue end <br />correct. All provisions of laws and ordrnances governmg this type o/ woric will be completed <br />whether specified herein or noL The granting o( a pennrt does not presume to give authonry to <br />violate or cancc � the provisions o/ any other sfate or local law regulating construction or the <br />performance oI construction. That 1 am authonzad by the owner of this propeRy to pe�form the <br />work lor wh.ich application is made and I comply with fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />FoCn(�'��0 � <br />