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ELECTRICAL <br />PERMIT APPLICATION <br />CITY OF EVERETT PEPMIT 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />S�tl P vvl' d <br />PROJECT ADDRESS <br />(_ i CL 17)L �1r1 PC) DOx 2 ( �✓LLLICI L TE0 <br />Owner Mail Address City <br />Tenant Mail Address City <br />WA gs,)75 (ti rs) 353- 7070 <br />State/Zip Phone <br />psc.l� ��ecltii�Iv�c. poaux loos L0 SreVevi.s <br />Electrical Contractor Mail Address City <br />sc Li IFE 3Cti' i' <br />State License Number <br />c�� 1t FarrnLyt residehcy, <br />Proposed Use of Buildin <br />Description of Work to Be Done: 17yey lq dctA JL)lj?' <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 />State/Zip Phone <br />wA 96-mb 4zs39gg� <br />Stateop Phone <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That/ am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />(o -1'7 -o S <br />FEE <br />;5.: ti <br />