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i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 6`r � o <br />3200 CEDAR STREET, EVERETf, WA 98201 5q� <br />425-257-881U - FAX 425-257-8857 — www.everettwa.org �y p ctt�j6—d � O <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />(�� c� � C ���-�✓2%'f (�(.fC{ L -C �Y <br />PROJEC7 ADDRESS <br />f�-t-'� INS o A..� <br />Owner <br />�-H—��s L � <br />Tenant � <br />7�fF 71q� <br />Electrical <br />Address <br />�! <br />Mail Address <br />� o S � �v`4"p �- �!/P�e 7'� wG�¢' <br />►,PS �i�'t`r l-[. wu�!'` l�'%. <br />�C� � �_. � �R�� State2ip <br />/u,,5 c�ua aC. �dEi <br />���'� �� ����� <br />State L cense Number <br />GSC'� I � <br />Proposed Use of Building <br />Description of Work to Be Done: ^"—� S%Ct L- <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 />City <br />City <br />�'� L <br />SlateRip <br />Slale2ip <br />Phane <br />-v in- � <br />Phone <br />�23'2Z t2 <br />Phone <br />��. �� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />y certi(y that 1 have read and examined this application and know fhe same to be frue and <br />, All provisions o(laws and ordinances goveming fhis fype o(work will be completed <br />r speci(ed herein or not. The c�renting of a permit does notp resume fo give authonty fo <br />o; cancel the provisions of any ofher stafe or local law reg�/afing construction or fhe <br />�ance of construction. That 1 am authorized by the owner o/this properly to perform fhe <br />r which application is made and 1 comply wifb fhe Sfate Contractors Law 18.27 RCW and <br />, <br />FEE <br />���tc(o-OSS <br />