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ELECTRICAL PERMIT APPLICATION <br />CITY rJF EVERETT PERMIT SERVICES <br />?200 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 />,5�/.5 - ��J'T ;�OZ. <br />PROJECT ADDRESS <br />GA�LvL/lfv.2T E L._2AsJiN, <br />Owner Mail Addres� <br />iL'ONF <br />Tenant Mail Address <br />/; ri.� r r �, s�- <br />Electrical Contraclor <br />State License Number <br />�ll�'% L <br />Proposed Use af Building <br />��1� <br />Mail Adtlress <br />rTs, T� S' lv. � U <br />City <br />City <br />City <br />State2ip <br />Slate/Zip <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />�-/ 2 S <br />Phone <br />Fhone <br />Phone <br />Description of Work to Be Done: ,� E,�L� C F_ f� L L 0� %�/�:�F G�L /� _ j�i,! /Z �! N� <br />__%'/l.' <10 G�S � '1'- � C� T L E TS i- �,T (rH T S' LLi ? �% f".3' 7" <br />— A n 17 � C E_Z L.T /�' C�- LT �rH T1' <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 />I hereby ceRify that I have read and examined this application and know the same to be true and <br />correcf. All provisions ol/aws and ordinances govemmg th�s type o/ work �vill be completed <br />�vhether specified herein or not ihe grenting ol a permd does not presume to give authority tc <br />viclate or cance/ the provisions of any oth=r state or local law regu/ating construction or the <br />penormance of construcLon. Tnat 1 am authonzed by the own �r o/ this property fo pedorm the <br />wcrk lor which application is made and I compty with the State Contracfors La�v 18.27 RCW and <br />296.200 WAC. <br />/! <br />FEE <br />