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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 <br />L/yC�G �.,n,.�9/��v� ��-�,.i-1 w� ��'z4/ <br />PROJECT ADDRESS <br />��c�rt �_��r '�S ��yC'L, C�. .I %�• �r'i,.��{�" `(�'l.F �'�[O� ��0�-���-�5� <br />Owner Mail Address Ciry Slate/Zip Phone <br />Tenant <br />(�J c �_ •{ r"' <br />[leclrical ConUaclor <br />Slate License Number <br />A1ail Atldress <br />Mail Address <br />�;J c rb�,`�j l, c, �� —�,1 c, g�� <br />Proposed Use of Building <br />City <br />City <br />I� n � <br />Description of Work to �e Done: �� C ��', ` �' c�' .- <br />NOTE: 1NIRING IN NON-DW[LLINGS IS REQUIRED TO <br />EiE IN RACEWAYS, MC OR AC CAE3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stale/Zip <br />Slate/Zip <br />Contract Price of Work <br />,�P����:.��,��..a s <br />ConlactPerson (Plan Review) <br />FEE <br />! hemby certi�y fhaf lliave read and exarnined Ihis applicalion and know fhe same fo be t�ue and � clp p1 —(',� 7`7 <br />correcL All pini�isions olla�vs and ordinanrns govermng fhis fype ol work will be complefed <br />whetherspealied herein ornoL The granfing o/a pernut does nof resume fo give aufhcrity fo <br />violafe or cance! the provisions ol any ofher statu a-local law reguPtinc� consfruction or fbe <br />performance o/ cons(rucfi�n. Thaf 1 am �uthorized by fhe ou�ner o/ fhis propeRy fo perfonn 1he <br />�vork lor �vhich applicafion is made and I cornply with the State Contracfors Law 78.27 RCW and <br />296200 WAC. , <br />i ., __._\ , . <br />r� �ne <br />Phone <br />