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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEREiT PERMIT SERVICES ,z �,g _o� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org �,� p'�/ Z�/ D� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />J �'�� <br />� ���r���,l�n��� A Vc- <br />PROJECT ADDRESS <br />O�mer <br />Tenanl <br />M11ai1 Address <br />Mail Address <br />City <br />Ci�y <br />«. <br />�--'Mr(�.�T �l-��(�T"M—�L- INC % i,ii� �LC7�S1" � ( /' <br />Electrical Contraclor Mail Address City <br />5)rr�P�� IE I r��� IC.Z� <br />State License Number <br />� C�LJ r�� I V`���.� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />�d <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Slate/Zip <br />State/Zip <br />State2ip <br />Phnne <br />Phone <br />�-`)2 3v a 5 75 i <br />Phone <br />Conlracl Price of Work <br />Conlact Person (Plan Review) <br />I herehy certity lhat 1 have read and examined Ihis application and knuw the same to be true and <br />conecl. All provisicns e/ /aws and ordinances govemmg Ihis type o/ work will be completed <br />whefher specd�ed herein or not The granting o/a permd does not resume to give authonty to <br />violate or cancel the provisions ol any ofher sfafe or focal la�v reguPfing construchon or the <br />performance ol construchon. That 1 am authorized 6y fhe owner of th�s preperty to perlorm the <br />�vork lor which applicafion is made and 1 compty with the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />��-���-C� <br />FEE <br />� _��7/ <br />�1� <br />