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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />�� �� - ����� �� <br />PROJECT ADDRESS <br />Tenant <br />S� <br />Mail Address <br />Mail Atldress <br />Mail Addre� <br />C��NT�S f� � 30 �K <br />Slale license Number <br />Proposed Use of Building <br />'N' 71JI'tf�W <br />City <br />Clty <br />G� l'���J-�nl �1 <br />City <br />Descnption of Work lo Be Done: 1� v �v <br />�1-'� �- 'To r� l.�f,�,�J <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��l <br />(� Ev� ��� <br />� <br />—� Stale2ip <br />Stale2ip <br />�JJ� Gt/r9 <br />SlalelZip <br />� - a b -ra <br />[-/ov7 //b <br />q�2D3 Ig � <br />Phone <br />Phone � / '� <br />( �!' <br />��27Z 7 <br />Phone <br />�b25,' <br />Contracl Price of Work <br />Contacl Person (Plan Review) <br />I hereby certify that 1 have road and examined fhis application nnd know fhe same to be truo and <br />correct. All provisions olla�vs and ordinances �ovemmg this fype a! work will bo completed <br />whother spoabed herein or not The granting ol a pemut does nof preswno fo give authonty to <br />violate or cancel tho provisions oI any ofher state or local law regulaGng construchon or fhe <br />pedomiance olconslruchon. That 1 am aufhonzed by fho owner o/ this property to pedorm fhe <br />�vork /or which application is mada and 1 comply �vith the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�E <br />FEE <br />J UC�� - / I (o <br />