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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT 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 <br /> o?�/a L�'-.terr /�a� <br /> PROJECT ADDRESS <br /> Owner A1ail Address Ciry Stale/Zip Phone <br /> 57�ti� Cv�!/,e.:�s _ <br /> Tenant Mail Address Ciry State/Zip Phone <br /> �l�/� �L�B7�'lPi /�O,8d1C /�� �•t/tY/et//S/t �iQ �2Y�� c.�d S?� <br /> Electrical Contractor Mail Address Ciry State2ip Phone <br /> SF•LU/E�6�jpu �l�rSb � <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description of Work lo Be Done: ���/�9KJ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerlify(hat I have read and examined this application and kno�v fhe same fo be true and <br /> correcf. All provisions ollaws and ordi�mnces c�ovemmg fh�s type of work will be completed <br /> whether spealied herein or noL The yranting o/a pernuf does not resume fo give aufhonty fo <br /> violate or cancel(he rovisions olany olher state or local law rec�uPtinc�consWction or fhe <br /> peifommnc � That 1 am aulhorized by the owner oI this propeNy fo perfomi fhe <br /> work I iich app i..aGon�s rn de and I comply�ailh fhe Stafe Contractors Law 18.27 RCW and <br /> 296i� 0 WAC. <br /> � <br /> /Ct / d <br /> 'i� ture ' Dalc <br /> .�c;7rG — v(p� <br />