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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �� _03-0�% <br />3200 CEDAR STREET, EVERETT, WA 98201 �Olil�`��� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org 7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />��,1_ l_C.{l,lSr `��i�. <br />PROJECT ADDRESS <br />�t�l <br />Owner <br />Tenant <br />I�� <br />Address <br />Mail Addres< <br />:,�I yt53�3iizl <br />State/Zip Phone <br />State2ip Phone <br />���(;`��H l%1:E��tC It.IG.;'0�3Gx IOS_'� IAkESTCv'C�;S �vH-`isSZ-5g �fzS,�17-�47��5 <br />Electrical Contractor Mail Address Ciry Sule2ip Phone <br />1'�C��L'N �= i�,�iri 3 G� i <br />State License Number <br />Proposed Use of Building <br />Contract Price of Work <br />Contact Person (Nlan Review) <br />Description of Work to Be Done: ��L''"L��� ��i l{'— ���7 �1�� �� �'-f��� <br />NOTE: V1�'IRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRily that I have read and examined this application and know the same to be true and <br />correct. A/l provisions of /aws and ordinances govemmg this type o( work will be �ompleted <br />whether specibed herein or not. The granfing of a permd does not presume to give authcnty to <br />violate or cance/ the provisions ol any other state er local law regulating construc;ion or the <br />peAormance o/ consfruction. That I am authonzed by the owner o(Ltiis property to perlorm the <br />wodr for which application is made and 1 compl}� with the Sfate Contrectors Law 1 E.27 RC W and <br />296.200 WAC. <br />I- 3 <br />FEE <br />