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ELECTRICAL PERMIT APPLICATIQ6V <br />CITY OF EVERETT PERMIT SERVICES � <br />3200 CEDAR STREET, EVERETf, WA 98201 !� 7- / <br />425-257-8810 - FAX 425-257-8857 - www.everetiwa.org � � �� � ��� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7 � C �� U �..a 1^i M a v- (� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />< LIAIN"G �I l���V� <br />!i <br />� <br />�I�� v�-�..I S <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />-U�Yt ZLC <br />Mail Address <br />G71� l-�r�%Nar'4� <br />clly <br />Cily <br />5�...7 C�c�.. 2c� �—c <br />.�� �vEEs 93 I � � �3%/�3 <br />State License Number <br />�� �"�" `` �`�— / ��ir�a( "G <br />Praposed Use af B' ding <br />Descriplian of Work to Bo Done: <br />NOTF: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />yas <br />E�. (�1,� lu2�8 3�iSy <br />Stale/Zip <br />Stale2ip <br />-� <br />Stale/Zip <br />�� CIU(�. "� <br />Contract Price of Work <br />Phone <br />Phono <br />1� <br />��- � <br />Phone <br />Conlact Person (Plan Review) <br />-� S - 1 �-� � <br />1 hereby ceriilylhat I have read and examined this epplicafion and know the same fo be true and <br />correct. All prov/sions ollaws and ordinances goveming fhis type of work will be comp/eted <br />whether specilied herein or not The granting o/ a;:errmf does not presume to give authority to <br />violate or cancel the provisions of any ofher state or local law regu/ating construction or fhe <br />performance o/construction. That 1 am authonzed by fhe owner of fhis properfy fo pedonn the <br />work Ior which application is made and 1 comply �rifh the State Contractors Law 18.27 RC W and <br />296.200 LVAC. <br />FEE <br />C—LIc��-035 <br />y <br />