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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 />I 4 1� 12 A � N iClz I�VG•' � VC/7cr/' <br />PROJECTFIDDRESS <br />�� `"�..o� <br />�07� Z --da-, <br />�3r�Z S%�71-1=tN1/ACiN ��{lS �Ai,V�c;z.f�Vc �l/'er?crTT �nZs�3�3-J��iS�/ <br />Owner Mail Address City Slate/Zip Phone <br />Tenant <br />Mail Address <br />Cily <br />State/Zip <br />Phone <br />C�'tirun� 4��c; . ��o i3nf IV22 i�'{Aa�su�//r Uv�• ��Zs)QTv-i��a <br />Electrical Contraclor Mail Address City State2ip Phone <br />C� c�,t�i u c-ic Q G�/ /� l3 <br />State License Number <br />��F Srl�t,��Ti11C <br />Proposed Use of Building <br />Description of Work lo Be Done: <br />� � SG��s <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />�L�l��lp%�' ���%��%��C' IJIc�I �%�'I`�l+lJ � �.�r I����A/ <br />ni)D�r i�,u <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 hereby certily fhat I have read <vid exemined fhis applicafion and kno�v fhe sarne to be true and <br />correcL All provisions ollaws and o�dinances c�overrnng this type o( work �vill be complefed <br />whefher spec�Ged herein or noL The c�ranfin� o/ a pernuf does not resurne to give aufhority fo <br />vio/afe or cancel fhe provisions ol any other state or local law re�uPting construchon or the <br />perlormance ol conslruction. That I arn aufhorized by fhe owner o( this property to pedorm the <br />tvork lor �vhich application is made arld 1 canply wifh fhe Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. .q / <br />: <br />/ � <br />_ ._— , i� �� �-i ��� <br />� <br />FEE <br />�U`]13-p�7 <br />