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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3-1 Z- ��!� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C- d�03--�� 'j/ <br />i <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-� ( ( �o � �;'�� 1 <br />"ROJECT ADDRESS <br />Owner <br />Tenant <br />J � rf�v�c����nc,�T; <br />Mail Address <br />Mail Address <br />��i,.nrniT E��.��� �J�� <br />Eleclrical Conlractor Mail Address <br />S��r�v�nlel ciu� K-�- <br />Slate License Number <br />(�.���E= x <br />Proposed Use af Building <br />City <br />City <br />�,3 26 i s+- S� <br />Descriplinn of Work lo Oe Done: ��rn1 ��'''� �rC <br />NOT[: WIRING IIJ NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />State/Zip <br />StatelZip <br />'��i� S� 2� � <br />Slate2ip <br />Conlract Price of Work <br />Conlact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieGy certily fdaf I have read and ex<vnined ihis applic<ition and know fhe same lo be irue and <br />correcL All provisions o(laws and ordinances govermng this fype olwork will be compiefed <br />�vhefher speci6ed herein or noL The granting ol a perrnd does not prosume to give authonty to <br />violafe or canccl the provisions o�any other sfafe er /ocal la�v regulafing consVuction or fhe <br />peiformance o/construction. lhat I am authoiized 6y the owner oRhis propert}� fo pedomi fhe <br />�rork lor �ahich applicafron is made and I comply wifb Ihe State Contrnctors Law 18.27 RCW and <br />296.200 L1�AC. <br />� <br />��-- �--- 3 _ , � _ � � <br />Sinna�me Date <br />f-EE <br />Phone <br />Phone <br />5 <br />_,y � ; i <br />Phone <br />(= U'C C `'> C � `1 <br />