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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 11 -Iy-DS <br />3200 CE�AR STREET, EVERETT, WA 98201 ����/,�jSS <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />/%•�� �����'����C ll..�' Sr ��f � <br />PROJECT ADDRESS / <br />�/> J <br />/'��,,,,, r i ��„� >��� t, �-, i���,3 �� /� , PrPOr 4.A S� o`:/3 y�=�s ;� z <br />Owne� Mail Address Cily Slate2ip Phone <br />Tenanl <br />� <br />Electrical Contractor <br />Mail AdJress <br />`�Pr�'.i 1.. <br />Mail Address <br />P�'vFi=i= Tu�7 �A <br />State License Number <br />,S' `'� .5••-.�j/� /z.�-���� ��J.�.�.�.� � <br />Proposed Use of 8uilding <br />Descriplion af Work to Be Dune: L✓� :�� 5 07` <br />NOTE: WIRING 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 />Cily <br />Cily <br />i c.i <br />r. <br />State/Zip <br />StatelZip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />I hereby certily thaf 1 have read and examined fhis npplication and know fhe same fo be fnie and <br />correct. All p�ovisions ol laws and ordinances governiny fhis fype o/ work will be completed <br />whefher spec�fied herein or noL The granting ol a pen�ul does not resume fo give aulhonty to <br />violafe or cancel fhe provisions ol eny ofher state or local law reguPting construction or the <br />pedomiance o/ consfruclion. Thot 1 am aufhonzed by fhe ownerol Ihis property fo perform (he <br />work lor which applicafion is made and 1 comply wilh fhe State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />/ <br />r' <br />FEE <br />S � — c.. <br />Phone <br />36u <br />�3s- E <br />Phone <br />