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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 FF.OM 8 AM TO 4 PM <br />��U-S .S� �%�/�'�crTf�4l( G�/c�y <br />PROJECT ADDRESS <br />�i�s�O� <br />� ngo9_oyZ <br />(h�GL ��G�lG�/ ^(�.5+ �:�C'� � S F.� I-✓L''.�t� cr% liT �z ( � G�/�. �U� <br />Owner Mail Address City Slate/Zip Phone <br />Tenanl <br />Mail Address <br />City <br />Sta�e/'Lip <br />Phone <br />�S� �'�� � F,.� ���i 7,f � s� � ��e.e � ����� B.z�� .�ss s�'�r� <br />ElecUical Conlractor Mail Address Ciry StaleiZip Phor,e <br />C/.S r7 c` L ir � D-Z.2 !7 _ <br />State License Nmnber <br />r� <br />,�� S � <br />Proposed Use of Building <br />Description of :Nork lo Be Done: <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 />�ts. <br />,j �X�. <br />Conlract Price of Work <br />Cunlact Person (Plan Review) <br />I hereby certily fhaf 1 have read and examined this applicalion ano kno�v ihe same to 6e frue and <br />correct. All provisions o/laws and ordinances govemm� fhis type ol �vork will be compieted <br />whether spea/ied herein cr noL The g�anting o/a pemut does not resmne to give authonty to <br />violate or cance/ fhe provisions o� any other state or loca! law rec�uPting construction or the <br />pedormance ol construction. That I am authorized 6y the owner ol this properly to perlorm the <br />work lor which application is made and 1 comply �ti�ith Ihe Sfate Confractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />?'� �S'�'�� <br />G <br />FEE <br />tU����'�z <br />