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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.everetriva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�C�.� c:`l C� a /�5 <br />PROJECT ADDRESS <br />Owner <br />�. l�/, '�� N-� � � �,� no<<ys <br />Maii Address <br />Tenant M11ail Address <br />/�D� . 5'e i- ✓, c-� s� 7`D <br />Eleclrical Contractor �'ad AdCress <br />State License Numher / <br />��� � /�i `� <br />, // �% `� / G( /J4/ 7 <br />Propose ae oF Building <br />��� � �� <br />Ciry <br />City <br />City <br />� <br />State2ip <br />State2ip <br />StatelZip <br />Contract Pnce of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: U,�% �/�f 4-<' T�' � �� %/�9 r� cs� h✓; C-� _S <br />� / /� e t,.�' c�v i•�v / %�5. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWP.YS, �1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereby certilv that 1 have read and examined this applicafion and knc�v the same to be true and <br />eorrecf. All picvisions ollaws and ordinances goveming ihis type o( wer'K wil! be completed <br />whefher specilied here�n or not. The gran(mg of a permd dces not presume to give authurity to <br />��iolate or cancel the provisions olany other state or local law regulating construc2ion or the <br />nertormance ol construchon. That 1 am aufhonzed by the owner o( this propeRy to peAorm the <br />.vcrk (cr which appiication is msde and I comply wrth the State Ccntractors Law 18.27 RCW and <br />296.200 WAC. / . <br />� , <br />�-/i/:��-`� /Y /' .� <br />Sign;� <br />� �� <br />FEE <br />G G4�'� <br />Phane <br />Phone <br />Phone <br />