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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.everetiwa.org <br />� � lD —/� <br />� ic�5-� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� 2 ( � rc...�—c� � v,Q <br />PROJECT ADDRESS <br />D��� <br />Ow�rer <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />�1 — <br />Slate/Zip Phone <br />State2iF Phone <br />Pras�ra�. e���-c,.L �,,.� 223a ,4-as.�.s � E�--r�t ,�.���82a� 4zs-Z4a -; <br />Electrical Ccntraclor htail Atldress City Slate2:p Phone <br />�(z�ST�� 9�'3 Gbi <br />� License Number <br />S-F.`t�_ <br />Proposed Use of Building <br />Conlract Pcce of Work <br />T� <br />Contact Person (Plan Review) <br />Descriplion o( Work to Be Done: W�'ro a��i ���� 1�..�'1i� �— �K�-1S �+iuta Ci j�u.�".S <br />NO � E: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />I here6y certily that 1 have read and examined this application and know the same fo be true and <br />r,vr?ct. All p�ovisions ollaws and ordinances govemmg fhis type of wcrk wdl be completed <br />�vhefher specified herein or not The granting o/ a permd does not presume to give author,fy to <br />violate or cancel the provis�ons ol any ofher state or local law regu(ating construction or fhe <br />peAormance ol construc;ion. That / am aufhonzed by the vwne� o/ this propeRy to peri�rm fhe <br />wcrk Ior �.vhich application is made and I comply wrth the State Contractors Law 78.27 RCW and <br />296.200 WAC. <br />..,-�.,.. <br />FEE <br />C���c � - U3'} <br />