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ELECTRICAL PERhIIIT A�'PLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, 1NA 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 />1-� C. � ��'l0� � ls(�IJ ST <br />PROJECT ADDRESS <br />Owner <br />)C 4Jc,�� �'oJ �� U_�c� <br />Mail Address <br />StalelZip <br />7 <br />Phcne <br />Re� fa � �-I z i h,a ��o,.i s,— ��E�r�-1�{� � fl-. <br />Tenanl Mail Address City Stale/Zip Phone <br />Shoc.� r�o nn ho mes y25- i��_�P�, <br />Electrical Contraclor Mail Address Cily State/Zip P'hone <br />Slate License Number <br />� To.�ci c� � <br />Proposed Use�,Building <br />Descriptian of Work to Be Done: ��0 /t ��> e� v�. e <br />�dOTE: 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 />�� �� ��� <br />Contract Price of Work <br />Contact Person (Plan Revicw) <br />i hereby certily th3t I have read and examined this applicafion and know (he same fo be Uue and <br />correct. All provisions o/la�vs and ordinances govermng this type oI work will Ge completed <br />whether spea6ed hercin or noL The granting of a pemut does not resume to give aufhority to <br />�iolafe or cancel the p�ovisions ol any other state or lor�l la�v rer�u�ting construction or the <br />pedormance ol conslruction. Thaf I am authorized by the o�vner o! this property to perlorm the <br />work for which application is ntade and 1 cnmpty wifh the State Contractors Law 18.27 RCW and <br />296200 I��AC. <br />FEE <br />���7�/3C�' <br />