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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 a_ � S- v� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.or3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />8((c C r�tnr�i�f� viv .� C►_�vC <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />I� 5I (V� ��� <br />Electrical Contractor <br />�Mail Address <br />Mail A6dress <br />��. � IL <br />Mail Address <br />i!,r.�C��? �� ��i,+��ix.u)i� (.v <br />City <br />Ciry <br />� r,�. ,�r�- � <br />lLM r r,t=c � r�-)l--_1 h / <br />State License Number I <br />S r-� <br />Proposed Use of �uilding <br />Description of Work to Ee Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 IL'L-I l' v"T�7� <br />State2ip Phone <br />Slate/Zip Phone <br />>I 2j Z� `"�407 <br />State2ip Phone <br />�� I fY �l � ."' <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />1 hereby certity that 1 have read and examined this application and know th,e same to be true and <br />cerrec:. All provisions o/laws and ordinances goveming this type ol wcrk �vdl be completed <br />whefher spea6ed herein or noL The granfing ol a pernut ooes not presume fo g�ve authonty to <br />violate or cance� the pro��is�ens o(any other state or!ocal law regulating construction or the <br />pe�formance o( construction. That I am authonzed by the owner o/ this properYy fo perform the <br />waK (or which application is made and I ccmplv �vdh the Stafe Cuntraclors Law J&2i RCW and <br />296200 WAC. <br />z�-��s <br />