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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 />�� � � : �s �,,,� � . �, <br />. <br />PROJECT ADDRESS <br />� r L <br />��a.c �r � � �.��,'��� �....[ C�YvI% _ �Y: y»!90 _l7•'4✓) 3M <br />Owner htail Address City SlateJZip Phone <br />`�� `�1 <br />Tenant <br />��'ine �'�.i I <br />Eledrical Conlnc�lor <br />Slale License Number <br />i. .�, ,� r� I <br />proposed Use of Buildin� <br />Description of Work to Dc Done: <br />Mail Address <br />A1ai1 Address <br />IJOTE: WIRING IN NUN-DWELLINGS IS REQUIRED TO <br />CiE IN RACEWAYS, MC OR AC CABIE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />Slate2ip <br />Slate/Zip <br />Contrect Price of Work <br />Contact Person (Plan Review) <br />I hereby certity thaf 1 have read and examined tnis applicafion and know the same fo be tnie and <br />con�ect. All prry�sions o/laws and ordinances got�enung fh�s fype ol work �rill be completed <br />n�hethe� specnwd herein or noL The granfing ol a pennd does nof presume to give authonty to <br />violale or cancel fhe provisions o( an}� other s(ate or local law re�ulafin,q construchon or the <br />peAormance oI construchon. That I am authaized by fhe ewner ol this property to perlomi fhe <br />work lor which application is made and 1 compiy with the State Contracfor Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />"? : l."'%^ � <br />Date ��C�-7�." � � � <br />Phone <br />Phone <br />