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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 />1�05 i/f)l'/��iV.�itl ,P� S7F-�� <br />PROJECT ADDRESS <br />Ownef Mail Addrass City <br />State/Zip <br />� -d -to <br />��oo �_or3 <br />Phone <br />%'/�D H�Nv/�f�c�u�T ��o� fI�1�l�•v.�J•v /1Dr�E'`'f �a�,PFi� ��A, %lZa3 <br />Tenant Mail Address City Slate/Zip -�3�hop�-, <br />�.�/�t'�Fl�i� �i,s7 ..� hl'Sr"i <n � 3/z��i%rtl/�,n� i.u�. 9fi'0) � �tz )7_m—/c <br />Eleclrical Contraclor Mall Addross <br />�n //�F� 7�Z-7 C'S Y- 7- I�- <br />Slale Liconse Number <br />Proposed Use oi Building <br />C <br />Cily <br />Slate2ip Phone <br />%%'iD 6S3 3 <br />SaDo `= <br />Contracl Price ot Work <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACCWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hen:6y certily thaf 1 have read and examined Ihis applicatiat and kno�v the same to be fruo and <br />correcL All provisions olfa�vs and oidinancc . 7overnmg this fype of n•ork will bo camplefed <br />whefhe� spec�lieAherein or nol. Tho �ranting o/ a pernut does not �resumo fo give authonty to <br />viofate or cancel the provisions o/ any ofher sfate or local law regulating consfrucfion or Uie <br />perlonnance o/ cons(ruction. That I am aufhonzed b}� the o�aner o/ this prope�fy to pedonn the <br />�vorB lor which applicafion is made and 1 compl}� wifh the Sfate Contractors La�v 18.27 RCW and <br />29G.200 lh:4C. <br />7/�/2o/a <br />FEE <br />I `�� ��� <br />� <br />