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ELECTRICAL PERMIT A,PPLICAT�ON <br />CITY OF EVERETT PERMIT SERVICES /' <br />3200 CEDAR STREET, EVERETT, WA 98201 !(���bY <br />425-257-8810 - FAX 425-257-8857 — ww�,v.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEP'iED <br />� 2 S� ��� g!� so -� sr� <br />PROJECT ADDRESS <br />Owner <br />�---^ <br />Tenant <br />EIec�Contr� <br />.,-���s �'a <br />Mail Address <br />Mail Address <br />-- � l�/�C <br />M�il Address <br />State License Num�er <br />��� 5,�����-- <br />Proposed Use of 8uilding <br />Description of Work to Be Done: <br />��� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COL� IS 3105 <br />1 here6y certily that I have read and <br />correc7. Hll provisions of /aNs and c <br />whetherspeci7iedhereinornot Thi <br />violate or cancel the provisions of ai <br />performance ofconstruction. Thatl <br />woik (or �vhich application is made a <br />296.200 WACr�� � <br />� <br />.�/� /�7� ►�/ ��i�l{un� S'$� 3 <br />Ciry <br />Cily <br />City <br />��i <br />Slate/Zip <br />State/Zip <br />Slale/Zip <br />Contrect Price of Work <br />Contact Person (Plan Review) <br />this application and know the same to be true and <br />governing this type of �vork will be comp/eted <br />�l a permif does not presume to give authonty to <br />�te or local law reguiat�ng construcLor or the <br />'zed by the owner cl this property to peAorm the <br />y with the S(ate Crntractors Law 18.27 RCW and <br />� <br />v / o <br />FEE <br />r <br />Phone <br />Phone <br />Phone <br />�/ <br />;/ ( ��II �' <br />L� <br />