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ELECTRICAL FERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ��-�7_oy <br />3200 CEDAR STREET, EVERETT, WA 98201 C 0�// 2—/Z� <br />425-257-8810 - FAX 425-257-8857 — �v�n�.v.everettwa.org <br />APPLICATIONS ARE ACCEPTED F!20M 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />' � <br />����LS 1����rC�f���,v �-� s.,��I��� <br />PROJECT ADDRESS <br />Tenant <br />Mail Address <br />Mail Address <br />�c,<<s' L� �i� �(.t-���C <br />Conlraclor � Mail P.ddress <br />�� ;��,Icic�-���>C— - <br />State License Number <br />Praposed Use of Building <br />Description af Work to Be Oone: <br />i /, <br />4rL���f'S�nl �� f ��v'i <br />c�ry <br />City <br />i)�h i� �uiY-c(�A/,���� <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES'lAX CODE IS 3105 <br />W f,� � <br />State2ip <br />StatelZip <br />c,., <br />Stata2ip <br />�2�_� . <br />_ iUcr <br />Phone <br />Phone <br />y�--yb l <br />---`�� <br />Phone <br />� �- ,-� �s ��: <br />Contract Pr�ce of Work <br />Conlact Person (Plan Review) <br />1 hereby certi(y that I have read and examined this applicafion and hnou� the same to be We and <br />correct. All provisions of laws and ordinances govemmg this type e( work wdl be completed <br />�vhefher speci6etl herem or not. The granting of a pe�mrt does notp resume to give authonty fo <br />violate or cancel fhe provisions o(any other state or local law regulatirg consfrucUen or the <br />periormance o( consVuction. That / am auLhenzed by fhe owner o(this property tu pedorm the <br />�vo�k rcr �vhich application is made and I comply �iith the State Contractors Law 18.2� RCW and <br />295200 WAC. <br />�;; i�, �� - � � -�� - <br />SiG�amm Date <br />FEE <br />i;�ti�z-�z4�. <br />