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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 - DEBIT & CREDII' CARDS ARE NOT ACCEPTED <br />�� r„ ,_.�� y3z3 oly��,4 �1✓�� <br />-�� . � , � <br />,� <br />PROJECT ADDRESS <br />5��.,..w. 2��7�cU� w ��r.��� <br />Owner Mail Address Ciry State2ip Phone <br />Tenant <br />Mail A�dress <br />City <br />State2ip <br />Phone <br />,��'�C�� i�e�.'i-f;` ��sz! �3�5''�3-e SL-. C,..��w--.S�..c.K� S.SZSG yu��)S-Ss:9 <br />Eleclrical Contractor Mail Address City � State/Zip Phone <br />�i � O� �' <br />, � � _ .�'. <br />�,�5�''LCyI `772. � i yvc� �� ' <br />State License Number Contract Price of Work <br />�,,,� L L � --�i <br />Proposed Use of Building ` Contacl Person (Plan Review) <br />Description of Work to Be Done: �. ��--- TeMc✓ L <br />NOTE: WIRING IN NOiJ-DWELLINGS IS REQUIREG TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thaf ! have read and examined fhis applicafion and know the same to be frue and <br />correct All provisions ol laws and ordinances governmg this type ot work wdl be completed <br />whefher specrlied here�n or not The grantin� oI a permd does not presame to give aufhority to <br />violate or cancel P�e provisions o/any other stafe or locallaw regu/ating construcfror, or the <br />pedormance of con.atrucLon. That 1 am aufhorired by the owner oI this property to perform the <br />work lor which applicnfion is made 3nd 1 cornply with ;he Sfate Cunfractors Law 18.27 RCW and <br />296.200 WAC. <br />-- .:���""ry l �._- �-1/f<' % . <br />SinnaWre Date <br />FEE <br />