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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />;� /c� "7 /�iGN���In;� /'1v� <br />PROJECT ADDRESS <br />G��'� 1 <br />�� r�v� �l J)ia�(IR���C�- -'�S:�x �! -�"n,ycn�✓�s lJW . iiG'�6 c?�6 GaS� <br />Owner Mail Address City State2ip Phone <br />Tenant <br />�WNFti <br />Electrical Contractor <br />State License Number <br />��/- f-1r � h-I�? <br />Proposed Use af Bui�ding <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />Sta�e2ip <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />Description of Work to Be Dane: �(�%�, /� �`t'l� Sri"'v��'i= (JPG�'i1rJr <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />1 hereby certily that 1 have read and examined this applicaticn and know the same to ba true and <br />correct All provisions ollaws and ordinances governing this type o( work will be completed <br />wnether speafied herein or noL ihe grantrng ola permit does not presume to give authority:o <br />viulate or cancc/ the provisions o(any other state or local law �egu/ating consWction or the <br />per/ormance of construc6on. That 1 am authonzed by the owner o( this propeRy to pedorm the <br />work lor which application is made and 1 compty with fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />I ) � <br />I� �/ " i• <br />, T!'�-_� .. <br />��� ��1�� <br />FEE <br />Phone <br />Phone <br />