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0 <br />ELECTRICAL PERMIT APPLICATION <br />Cll'Y CF EVERETT' PERMIT SERVICES <br />3200 CFDAR STREET, EVERETT, WA 98201 <br />425-257-881U - FAX425-257-8857—www.everetiwa.org <br />APF'LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SQ � Jt- <br />PROJECT AL`9RESS <br />,! r� <br />Owner <br />Mail Address <br />City <br />KGvll � �3 cE��e� sas S. � �� �l'I`� <br />Tenant Mail Address City <br />(! <br />.5'� �������i�'i% �1QY/Ce�r�� <br />ElecMcalContrector MailAddress City <br />����-��/. �O c�<� ( �`� � � <br />State License Number <br />r <br />.�c�z�-� C � S" a,��� <br />Pro osed Use of Building <br />Description of Work to 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 />I h=reby ceRrfy thaf 1 have read and examined this applic <br />correct. AI! provisions of laws and ordinances governing <br />whether specified herein or not. The granting of a perm�t <br />violate or cancel ihe provisions of any other state or loca <br />peAormance o/ consi tion. That 1 am authonzed by th <br />work for which appli tron is made and ! comply with the <br />296.200 WAC. <br />State2ip <br />Phone <br />�� �fJ �9 <br />Slate2ip Phone <br />� � �..$�J'• �%7- C G �.� <br />_ �,� <br />-�f <br />StalelZip Phone <br />��, o a <br />Contract Price of Work <br />Contact Person (Flan Review) <br />ation and know the same to 6e true and <br />this type ol work will 6e completed <br />does notp resume to give authnrity to <br />l law regu/atin,q con�truction or the <br />e awner of th�s property to perform the <br />State Contractors Law 18.27 RCW and <br />FEE <br />G�/1'Cu/ �S <br />���� ,�i3 <br />