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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cct7AR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� % l�a ; s o � f��M <br />PROJECT ADDRESS <br />Owner <br />Mail Addross <br />City <br />�ii��� <br />Tenanl Mail Address ���Y <br />y9�7 Ec <br />�/`i%_S_tf��l__�'/C�C di^r'C 1G?c �d�ePei� <br />EleclriciafConlractor MallAddross ���Y <br />.�Gff�' ��7cL <br />S ate Llcense Number <br />� �� <br />Proposed I se of Building <br />Description af Work to Be Done: <br />NOTE: WIRING IN IvON-DWELLINGS IS Rt'QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stale2ip <br />�_-�-`� `�� <br />�,—,� a� -��-7 <br />State/Zip <br />f'EPK �-�`�� <br />Stale2ip <br />Phone <br />Phone <br />'zz-2 <br />Phone <br />,�� � ��o <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby cerfify that 1 have read and examined fhis applicaGon and know the same to bo frue and <br />correct. All provislons of laws and ordinances goveming this type of work will be completed <br />whe(her speci�ed herein or noL The granting ol a permif does not presume to give authonty to <br />violafe or cancel the provisions of any ofl�er stafe or local law 2guleting construction or fhe <br />perlormance o( construction. That 1 am au(horized 6y the owner of thls property to perform Ilie <br />�vork Ior whlch application is made and 1 comply with tho Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�' ��ti 2`-� —z°�� <br />Signalure � <br />FEE <br />�I�D�S-13�-- <br />