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E�ECTRICAL PERMIT APPLICATION <br />)� <br />ADDRESS <br />Tenant i <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 <br />Mail Address <br />Mail Address <br />EIeCUical Gonlrac�or Mail Address <br />Slate License Number <br />i <br />I <br />� <br />Proposed Usc o( Building <br />R U� ��,.� �l <br />Cily <br />Cily <br />Cily <br />Slale/Zip <br />Slale/Zip <br />State2ip <br />z -3 -� Z <br />� � II I 1 —D6%� <br />�f. �� <br />Contract Price ot Work <br />�CK �-cpinS�r� <br />r <br />Contacl Person (Plan Review) <br />� �. <br />Description of Work to Be Done: �ot�� /� ��<�i�� /P�yL.. if <br />� . <br />NOTE: `NIRIIJG IN NON-DW[L�INGS IS REQUIRED TO <br />f3E W RACEWnYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE !� 3105 <br />! hcreby cerTily fhat I have iead and exantinr.d (his applica(ion anA know Ihe same to be twe and <br />con�ecL All provisions ol laws ond ordinances qoverning fhis fype ol work will Ge compleled <br />whefhr.r spealicd hemin or noL The pranfin� ol a perrnd does nof �resume fo givc aufhority to <br />violate or cancel lhr. provisions ol any ofher s(afe or local/a�v regul�fing cons6uction or the <br />per/onnance o/consfrudron. Thal ! am aufhonzed h}� Ihe owner o( fhrs properly fo perlornt fhe <br />wo�k lor wh�ch apP���afion is made and 1 comply wifh fhc Sfatc Contractors Law f0.27 RClNand <br />296.200 WAC. <br />Y.lf-1�o • 7��� <br />Phone <br />Phone <br />Phon� <br />r-e� <br />�l,Jl 1 � ! - c�� <br />