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ELEC7RICAL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEUAR 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 />— � //.� <br />7 <br />ll/l)d ���. r���ll /�i�/(�i�� . s�qrz.�� /'rr�lel��,�A <br />PROJECT A�DRESS <br />owner <br />Tenant <br />Eledncal Contractor <br />r Fi���u�r/ <br />Mail Adtlress <br />Mail Adtlress <br />Mail <br />�✓�R��� o"3yK-r <br />State License Numher <br />� �U� � / �l'C1�1 <br />Pro "osed Usr of Bu ding ' <br />D�scription of Work to Be Done: <br />NOTE: WIRING IN NON-DWCLLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAlES TAX CODE IS 3705 <br />c�ry <br />Ciry <br />City <br />StatelZip <br />State/Lp <br />Stale/Zip <br />���SU,C�(� <br />Conlract Price o( Work <br />Contact Person (Plan Review) <br />I hereby r.ertify 1ha( I have read and examined ihis application and know fhe same to Ge frue and <br />correct. All provisions o/ laws and ordinances govemmg fhis type o( work will be completed <br />whefher speci(ed herein or noL The granting o/a pertnrt does not presume to give aufhonty to <br />violate or cancel fhe provisions ol any other sf�fe or local law regulating construction or fhe <br />performance ol construction. Thaf I am authorized by the owner of this property to pedomi fhe <br />work Ior which application is made and I comply with the State Confractors Law 78.27 kCW and <br />FEE <br />c-' y�� . �u�S <br />Phone <br />FMne <br />Phonc <br />