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ELECTRICAL PERMIT APM�LICA�'ION <br />CITY OF EVcRETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.orc� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />'� / � � � � t��t��pZ` i j /j%�J L � (/,Jl.�y � �),r.�-�.0 i i / �< <` � <br />PROJECT ADDRESS <br />,j7i�4'.(/� n,%1� ��' i),t�B��%'�C/�� <br />O.vner <br />Mail Address <br />City <br />Stale/Zip <br />Phone <br />/ �' <br />s� t+��/ n� J ��6� S S/ � ��: ,Cdcr/i,c`i i�/'� �. �.,.�'�/ r �� Z� X <br />Tenanl Mail Address City State/Zip Phone <br />�,�,^.,> 1l,F f. <br />[lectrical Conlrector <br />� � \z'� 7�"� ( <br />Mail Addross <br />State License Number <br />�•�`� U iff I��K'.';/i���.: �. � /!, <br />Proposed Use of Building � � <br />Descriplion of Work to Be Done: <br />� 1�.`�. /(�F� W� ��G d � <br />�rta <br />C. .�' (`1 � iC � G ' ��, <br />NOTE: WIRIVG 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 />Ciry <br />1 hereby ceRily that 1 have read and exarnined this applica(ion and kno�v fhe <br />comecL All provisions of laws and ordinances goverrong this type ol �vork ��v� <br />whether specified herein o,- noL The granting o/ a pennd does not ��zsurne <br />violate or cancel fhe provisions ot any other state or local law re�ulaling con <br />peAormance of construc6on. That I am�authorized by the owner o( th�s prop <br />work !or which application is rnade and 1 on;ply wi(h the Stafe Confraclers L <br />296.200 WAC. � <br />—�-��� �c 4��`' D <br />Signature p <br />Eos o6. i 1 l <br />State/Zip <br />�� <br />U «A <br />Contract Price of Work <br />Contact Person (Plan Review'� <br />a� Cflinl/iL"i�✓iS/� <br />ome to be We and <br />6e completed <br />� give aulhority to <br />rucfion or rhe <br />ty to pe�lorm fhe <br />w 18.27 RCW and <br />�" <br />FEE <br />F'hone <br />