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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 />lo S��i �[?urLD e�5 o rJ R C(� <br />PROJECT ADDRESS <br />Tenanl <br />Eleclrical Conlraclor <br />Atail Address <br />Aiail �ddiess <br />�� <br />Mail AAdress <br />�' o r� P�t+'s o� z. t3s' <br />S�ate License Number <br />%�vnvt �u e.t�(��L/ v(,( <br />Proposed Use of Building <br />Descriplion ot Work to Be Done. <br />City <br />City <br />Ci�y <br />Slate/Zip <br />StatelZip <br />I„%/4,ri g'f O <br />State2ip <br />7�i 3�� <br />�o90�u�i <br />�f�r k0, <br />B',ZD3 D70�5 <br />Phone <br />Phone <br />' o?O6 -�g'Z-%D5 <br />Plionc <br />� / �'/?,�5/5 � � ° a <br />Contract Price of Work <br />ConlaclPerson (Plan Review) <br />1 O �EX�n.u��wc _/�uc�/.�ce S. /� 1�.a�S 1d-Z �2 �-l„1N3�'( <br />Gt'lc.,Q, � S ��,2�t �� <br />NOT[: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriily Omt I have read and exarnined Ihis applica�iun and knou� fhe same to be frue and <br />conect. A/l provisions o! la�rs and ordinances goveming this f}�pe o/ work will be complefed <br />i^hefhcr speal�ed herein or not The granting oI a pernut does nof resume fo give authonty fo <br />violnfe or cancel the provisions ol any other state or local la�v reguPting consfnrctron or fhe <br />pedormancc o/ consfruction. That 1 am authorized by Ihe owner of this property to peAorm the <br />work lor which applicalion is made and 1 compty �vith fhe Stale Con6actors Law 18.27 RCW anA <br />296.200 WAC. <br />�.� p._.��.- �i,��o <br />FEE <br />CLJ��i�— �]� <br />