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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 />� , , <br />%�'� % /�?,�'oc��S���,� �z— <br />PROJECT ADDRESS <br />� uJ �Til <br />�WfICf <br />� � �✓ <br />Tenant <br />�- <br />� �2 / �/Us� Sa..� � <br />Mail Hddress City <br />v �7�J�5 �i��./ G <br />Mail Address <br />� `� �-�,�/CLL <br />Electrical Contractor t.fa�i nddress <br />State License Number <br />Proposed Use of Duilding <br />Description o( Work lo �e Done: �� �` C' L( <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />�Z�-� <br />Cfgo_ zo�- 3��- <br />pJ y ,,�,�'oe�v, �X /�-z B 5�; <br />s� /J <br />City <br />City <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�e6y ceriily thaf 1 have read and exarnined Ihis aprlicafion and know fhe <br />correcl. All provisions o//aws a�d ordinances govenung this lype ol worh �+� <br />whether specilied herein or noL The granting o( a permd does nof vesume <br />violate or cancel the provisions olany cfher state or local law regulating con <br />pe�iormance ol consfru fwn. Thaf 1 am authorized b}� the owner olthis prop <br />worK lor which applicah�n is maJe and 1 comply �vifh fhe State Contractors L <br />zss.zoq�uac. , ;� � <br />C� <br />i ..�y�� ,� <br />� i <br />� <br />��y/ G'�,. <br />� � �latCLZi��� � ��one <br />C- �('�(J�%Lr '� L <br />Slate/Zip Phone <br />Slate2ip <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />%� � �1c�=1�-_ <br />�e to be frue and <br />� cornplefed <br />�ve au(honty fo <br />•tion or fhe <br />fo perlomi the <br />18.27 RCW and <br />FEE <br />� �i�C� � ' �/ � Z <br />Phcnc <br />