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ELECTRICAL PERMIT APPLICATION <br />6 m�^ -�' � ` <br />Evr,� <., <br />PROJECT ADDRESS <br />CITY OF EVERETT PERM[T SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />° .>< � <br />�• �--0� <br />L o�06 -/CzS <br />���t+� .r f i7,,�;r>< � Ih�c%s..r, �vc�1� � l.i� j� 2<� 3 (S�2S� 3Sv- 3il 7 <br />Owne� Mall Address City Slate/Zip Phone <br />Tenant <br />Eleclrical Conlrac�or <br />Staie License Number <br />�5'l� v,� <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Ciry <br />City <br />SWle2ip <br />si�i�rz�� <br />Phone <br />Phonc <br />Cuntrect Price of Work <br />���'� ��iC ►'� <br />Contacl Person (Plan Review) <br />Description o( Work to �e Done: ��P.�pe��-I�C SL�.�� �-e.lq c� G9� %�ix �.c,p <br />Aitc� 4N1.1 Ow�`��-S <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />[3E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(}� that 1 ha��e read and examined this application and know fhe some to be true and <br />correct. All provisions ol la�vs and ordinances govenung this type oI work will be completed <br />ivhefher speciGed herein or noL The granting of a pennd does nof resume to give au(honty to <br />violate or cancel (he provisions ol any other sfate or tocal law reguPfing construcfion or fhe <br />pe�fonnance o/ constnicfion. That 1 arn aufhonzed by fhe owner ol this property to pa�lorm tlie <br />wo�l<!or �ti�hich applicahon is made and 1 comply with the Stafe Contractors Law 78.27 RCW and <br />296.200 WAC. <br />-f� �/ L1_ <br />FEE <br />