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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 425-257-8&57 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`� 10 ����D �J� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />Tenant Mail Address City <br />�.'_P�;��ir, L�+�c-tGzlL �?�-� E�_�x 5 �_� � <br />Eleclrical Conlraclor Maii nddress ���Y <br />�%-A �`� � �T � �` � <br />Stalo License Number <br />.�5 i O�N ��. <br />Proposed Use of Oui�ding <br />State/Zip <br />Slate/Zip <br />T �2s� 1 �-1.2.� <br />StalclZip <br />Contract Price ol Work <br />Conlacl Person (Plan Review) <br />Phone <br />Phone <br />Dea:ription of Work l0 8e Done: ��S i�n?1-A � �-� iV��� L- —�-� A MP <br />����2��Z:��xJ D S�K�i c-L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC C1R AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi/y lhaf 1 have read and e.ramined Ihis application and kno�v (he sarne fo be hue and <br />conect. All provisions o/ laws and ordinances 9overning this type ol work u�ill be complefe!! <br />whether specdied hcrein or nol. The �ran(ing o/ a penm� does nol resume to give aufh �nty to <br />violate or cancel the �rovisions ol any otl�er sfafe or local law reguPfing consfrucfion or the <br />performance o/ consfrucfion. That I am authorized by Ihe owner o� th�s property fo perform the <br />work Ior which applicaficn is made and 1 comply �vith Ihe Slafe Contrac(ors Law 18.27 RCW and <br />296.200 W� /` <br />,��: ��/3 /� <br />FEE <br />