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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_a ��.�;7 <br />3200 CEDAR STREET, EVERETT, WA 98201 C-� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � 07 0�7 �� y <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />;'�`5 ,��/Nf.� <br />PROJECT ADDRESS <br />Tenant <br />A1ail Address <br />Mail Address <br />sfNs� FC��T,��� <br />Electrical Conlractor h7aii address <br />�ooDSE �*9.s9�,�a <br />Stale Lic�nse Nwnber <br />DENT��L _ <br />Propased Use ol �uildinc� <br />.3�/9 io���7" s� <br />Ciry <br />City <br />City <br />.�%v,rr �Tf� <br />slaterzip ��S 3�,—%SS/ <br />Stale2ip Phone <br />(�z s7 239 - 5960 <br />w� . 9�z�S _ <br />siaie�z�� <br />�'��i� <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />Description of Work to �e Done: Kf/ ��IL ���/k/ �/�L �' (i� ��%L .vf��T �/ <br />NOTE: WIRING IN NON-DWFLLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I he�eby certily fhat 1 have read and examined this application and know fhe same fo be true and <br />correcL All provisions ol la�vs and orAinances govemmc� this f}�pe o/ work trill be cornplefed <br />�vhe(her specified herein or noL The �ranting o( a pernnt does nof presume to give aufhonty fo <br />violafe or cancel fhe `�rovisions o/ any other state or local la�v rec�ulatir,� construcfion or fhe <br />performance of construcfion. That 1 am aulhonzed by the owner o/ fhis properly to peiform fhe <br />work /or �vhich applicafion is made and I cqmply �vilh fhe Sfate Confracfors La�v 78.27 RCW and <br />296.200 l4�ACI <br />� <br />� Q.iG�_ . ,s/�� �/ f'�i�/ <br />/:. <br />aic�nawre i- <br />FEE <br />f= c,�t oe 1� `� <br />Phone <br />