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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_,z-�� <br />3200 CEDAR STREET, EVERETT, WA 98201 � �� p7 —If q <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Sb6 �Lr�MOi� (3LI/�l EVE/�cil� CJA 9�2oi <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Conlractor <br />Slate License Number <br />Proposed Use of Building <br />$"(�6 ULY'iP�� <br />Mall Addross <br />Mail Address <br />Mail Address <br />(3�VD <br />City <br />Ciry <br />City <br />7 %'zo�, ,Zo� Y�Y 2 6 Z <br />State/Zip Phone <br />State/Zip Phone <br />Slale2ip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work lo Be Done: W I�' �N (, ��� A TCl� EQ �(i �� F <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 />I hereby certi/y fhaf 1 have read and examined }his applic <br />conect. All provisions ollaws and ordina��ces goveming <br />whether specifieAherein or nof. The granGng o/ a permd <br />violafe or cancel ihe provisions oi any other s(ate or /oca� <br />peAomiance o/cons(ruction. Thaf 1 am a�r�nonzed Gy the <br />work lor which applicafion is m� and 1 comply wifh fhe <br />296.200 AC. � <br />i � <br />,i ' ���C-'i ���{� <br />and know thc ame to be truo and <br />ype o/work will be completed <br />not presume to give authority to <br />egulating construction or the <br />er o1 fhis property fo perform the <br />Contractors Law 18.27 RCW and <br />FEE <br />Phone <br />Liin�-��q <br />