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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 g_%—� 7 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ��07� � y/ <br />C� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />;/Cu-t�� �—t ��Q� �—�o�(e� dh�e P�, ��e��� �� 9�a°`l <br />PROJEC'.ADDRESS <br />C� � l-lo •.�.�s /g/r� 5, l. S f�� <br />Q�y�� Mail Address <br />Tcnant A4ail Address <br />�,. ��tv�-��-/ � (cc �, � /��J9/r�e /, "51 <br />Electrical Conlractor Maii address <br />�" l7q�rtit <br />State License Number <br />l�.� ��, � ,� .-� <br />Proposed Use of Bui�ding <br />Description of Work lo Be Done: / C.C' W <br />Ci�y <br />City <br />Cily <br />�`CY�—l.t f, c� � t J u <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 />c.�4 q�a 5 g I�IZ�33j�-c�573 I <br />Slate�Zip Phone <br />StatelZip Phone ' <br />tJJ�. 1�d% ���Z'�I33o-?�9� <br />State2ip Phone <br />Contract Pri�e of Work <br />Conlact Person (Plan Review) <br />� TYa! [ Fa t1 Ll <br />1 hereby certily fhat 1 have read and examined this applicafion and know the same to 6e fn�e and <br />correct All provisons ollaws and ordinances �ovemmc� fh�s type of work will be completed <br />whether specilied herein or noL The granting ol a permd does not reswne fo give aufhonty fo <br />violate or cancel the provisions ol any o!her sfate or local law reguPting constn�ction or the <br />periormance of construction. That I am aufhorized by fhe owner ol fhis property fo perform the <br />work lor which application is made ana 1 cornply wifh fhe Sfate Confractors Law 18.27 RCW and <br />29G.200 WAC. /' � <br />FEE <br />9� .,..� <br />