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L�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CED.AR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCEPT[D FROM 8 AM TO 4 PM <br />���C? Z SC l.'f/! tf J'�I Gt // C(/i'; v— <br />PROJECT ADDRESS � <br />Owner <br />Mail Address <br />Cily <br />lr <br />3 -ad-�3 <br />C /�d 3 -I63 <br />Phone <br />1,.• � �i. C'/ctl� �t¢.i 9 � <br />Tenant Mail Addre s City State/Zip Phone <br />S>. f��v� ('t71,1' r L/cr-� S <br />Electrical Conlraclor Mail nddess <br />.� �1 C��� -� �jy�/ !�i , <br />ale License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Slate/Zip <br />Phone <br />�� <br />���r��s' — <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />1 hereby certily fhat 1 have read and examined this application and kno�v fho same to be frue and <br />correcf. All provisions o! la�vs snd erdinances governm� t!iis type o( work will be completed <br />�vhether specified herein or not The granting ol a pernut does nof resume to give authonty to <br />viclate or cancel fhe provisions o(any other sfate or /ocal /a�v reguPting construction or the <br />perlormance oI consfmction. That 1 am aufhorized by the owner o(this property fo pedorm the <br />work for which applicatron is made and 1 comply with the Stafe Contractors Law 1827 RCW and <br />296.200 WAC. <br />FEE <br />�� �, �j C; <br />�- ( '�C � - J i�' "� <br />