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ELECiRICAL PERMIT APpLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S'TREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - ww�v.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/ rJ/ � L� f'/.�1.!/� �%1C <br />PROJECT ADDRESS <br />, - <br />;L <br />owner <br />Tenant <br />Eleclrical Conlraclor <br />Stalc License Number <br />Preposed Use of Building <br />�s���' r°� l3,� Zo <br />P.�ail Address- <br />�v1ai1 l�dtlress <br />Mail Add�ess <br />City <br />City <br />Ciry <br />Description of Work to Be Done: �j� !� %�=� �J'C'«CL'� <br />� i <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE W R�CEWAYS, MC OR AC CABIE. <br />CITY �F EVERETT LOCAL SALES TAX CODE IS 3105 <br />StatelZip <br />Slale/Zip <br />Slale/2ip <br />Contract Price of Wo�k <br />�_ y-�� <br />�-a�o�.�� <br />Contacl Person (Plan Review) <br />y cr.rti(y that 1 have read and examineA this applicalion and kno�v the same to be Vue and <br />. AI! provisions o/laws and ordinances governing this type o/ tvork will be completed <br />�r specdred herein or noL The granfing ol a permd does not presume to give authonty to <br />or cancel lhe provisions oI any o(hr.r sfafe orlocal law mgulafrn� construcfion or the <br />�tance o(constnichon. That I am aufhorized G�� the owner o/this property fo pedonn the <br />�r,�fhich applioation is made and 1 comply �vith the Stafe Contractors Law 7d.27 RCW and <br />FEE <br />z <br />Phone <br />Phone <br />Phane <br />C;.'YC/-G � � <br />