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ELECTR�CAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SER,VICES a�q.�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C CS� �'��'S <br />AFPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DFHIT & CREDIT CARDS ARE NOT ACCEPTED <br />.1�� %(�� /'�1�;, <br />PROJECT ADDRESS <br />Cwner <br />/ <br />Mail Address <br />Mail Address <br />City <br />City <br />�; <br />State/Zip <br />State,'Zip <br />Phone <br />Phone <br />� <br />`�� � C—'1�-c-1-�i�<<�,� i�rio ,��-��� ��lJ(� ��'�� ��li��c�'P . �z'f� ����� ,�C����� <br />Electrical ConLactor Mail Address City '��•\ State/Zip Phone <br />,� <br />��/-��-ISC_�l_'n`-��7�i I> S � j i i,� ,� �����"/� <br />State�License Num6er .�: I��� ,-- Co ract Price of Work <br />i� � <br />C����C��(�f�/�jC:G� ������t.AC� — <br />Propo;ed Use f Building <br />Description of Work to Be Done: /� `C; G� !� <br />n <br />j - �3/'d�(�L.C'��('.)�� Li ��i; : <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLF. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />1 hereby certily that I Itave read c <br />correct Quprovisions ollaws ar <br />whethr -� � ,.: �ci(ied herein or not. <br />violafe or �dncel the provisions o <br />performance olconstruc6on. Th <br />�vork lor which application is mac <br />296.20f, WAC. <br />) / <br />,-� <br />Contact Person (Plan Review) <br />this applicatior and kno�v the same fo be true and <br />9oveming this fype ol work �vill be comp/eted <br />�I a permd does rot presume to give authonty fo <br />�te orlocal law regulating conSVuchon or the <br />ized by the owner of this propeRy to peAorm the <br />V wifh the State Contractors Law 1817 RCW artd <br />`'��; -�I a <br />�, <br />FEF. <br />'t <br />