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ELECTRICAL PERMIT APPLI�ATION <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 />i z --��--DU <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�017 Na�w�JS�A-l.� ��iJF <br />PROJECT ADDRESS <br />J�i(i�0� ����� S� � <br />Owner Mail Address City S:ate2ip Phone <br />Tenant <br />Mail Address <br />�IG E�CTiZ�C �uJC. <br />Electrical Conlractor Mail nddress <br />Ei 1 �' �=i-�F �'� 3Lr <br />State License Numbcr <br />City <br />P. o. Gox 3s7 <br />�-t��� -��r��y �=_s�o�=������ <br />Proposed Use of Building <br />City <br />State/Zip Phone <br />C36o� <br />�aoNor1�5F1 w� �'82`! I SbS <br />Slate2ip <br />Phone <br />' 3 � N 6� <br />D�"��r-rr � �-0 <br />Contraci Price of Work <br />S�.iC 6�w��i <br />Contact Person (Plan Review) <br />Description of Work to Be Done: r=l'�C� �C .'�L �11 � N� bF `�� S(� 1=N1 nZ <br />�1 � <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that I have read and exam;ned this application and know the same to be true and <br />cerrect. All provisions of laws and ordinances goveminq fhis type o( work wtll be completed <br />�vhe(her spec;hetl herein or not. The gran(ing ol a permd oces notp resume to give authoriry to <br />v�olata or cance/ the provisions cf any other stafe or local law regulating ccnstructicn or rhe <br />peAormance ol canst�uclion. 7'hat / am authonzed by the owoer oi this property to perform fhe <br />werk rcr u�hich applicaticn is made and 1 cemply �vdh the State Cuntractors Law 18.2� RCW and <br />296.200 WAC. <br />�t�--+� ' <br />FEE <br />��-\( 2-125- <br />