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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 — wv✓w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��iX�� Sr� �,n.i lJy� � �_. <br />�='�; ✓ � �[72, tl �7 r= <br />1� 2S oi �9�Lw.9�/ <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Eleclrical Contnclor <br />Stale License <br />�- c <br />n �c.c,�-,—•� <br />A1ail AJdress <br />Mail Address <br />-1 / � <br />�fail Address <br />yr�t .��-�i c--.� <br />Proposed Use of Buildin� <br />Description of Wod. to Be Done: <br />��'C'c% <br />c��y <br />City <br />cny <br />NOTE: WIRING IN NON•DW[LLINGS IS REQUIP.ED TO <br />BE IN RACEWAYS, h1C OR AC CAEiLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />C'�.�� � S i <br />xt'.—J' <br />l�u��7T `%ur'/Zc�l <br />si�i�rz�u r�i��„� <br />Slate7Zip Phonc <br />si��e.z�n <br />Fhone <br />� p��.6L-� <br />Conlract Price o( Work <br />/ ., <br />��v_A�!%.��z.�x <br />Contact Person (Plan Revic�v) <br />i neret�y c�n�ry Ihat 1 have read and exarnined this application and know the same fo be true and <br />correcf. All provisions o( la�rs and ordinnnces governmg this type ol �sak will be complefed <br />whether spea6ed h�rein or noL The granting o! a pennd does nof resumo lo give authonty to <br />violate or cancel fhe p�ovisions ol any other stafe or local law reguPtinc� consfruction o� the <br />performance oI cons6uchon. That 1 arn autho�ized by the oivner o/ this property fo perform (he <br />woik !or �vhich application is maAe and I compty u�i(h the State Confractors Law 18.27 RCW and <br />296.200 VVAC. <br />FEE <br />i" <br />C� <br />�1— �i Y'/Y7/ <br />