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E�ECTRICAL PERMIT APPLlCATION <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 � f7 - b S-as <br />`�� b S-f ��t I S �� tl�"� � C SO �,l ►` o A-t� <br />PROJECT ADDRESS <br />�, - �30 •- 8�s1 <br />Owne� Atai� Address City StalelZip Phone <br />►�1Prcer .Iyf�,�,�� w�A- <br />�R-�Co/Z C�;aS•j- (NC `�L�ST SL 3�'F`� Si'_5����t Zlb `3 `c�/Oy' <br />Tenanl A1ail Address City State2ip Phone <br />� <br />`-f 2S -y�'d- � �c . <br />b t� i'LN L`: C' L�ZiYL� C-!� � �C V�P r`e�"� Z510 �1-t.cF s"� �verez( �'�r4 <br />Eleclrical Conlractor Mail Address Ciry State/Zip p� �_Phon � <br />Lv <br />Slale License Number <br />Proposed Use of Building <br />Description of Work lo Be Done: � t�"� <br />NOTE: V��IRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />FEE <br />1 hereby certily fhat 1 have read and exarnined this app/ication and know fhe same lo be frue and <br />correct. All provisions ol laws and ortiinances governing this type ol work will be completed <br />�rhether specdied herein or noL The granling o( a penmt does nof resume fo give authonty fo <br />��iolate or cancel Ihe provisions ol any other stafe or local la�v reguPfing construcGon or fhe <br />perlormancc o� construction. That 1 am autl�orized by the o�vner of this property fo perfomi fhe <br />work Ior which application is made and 1 compty �vifh fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. � <br />o �- j-vs <br />