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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 425-257-6857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�,,�-�D�� � �(-�,�,p-�L l�r- - <br />PROJECT ADDRESS � <br />Owner <br />Tenanl <br />V �� i`�.1 �'< < � .� G2. .n-•-� — �-1. Z `� � fr � Z —4- %�� ( <br />Address <br />Mail Address <br />Cily <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />fl �=h �L�_� � 'r-= lL "�UU� ���� �r ��.0 '� ��oltcv�-��4,h, �i32`7� <br />ElectricalConlraclor MailAddress City Stale2ip �+Z�_y��z�hone <br />i' �l5— <br />n �,��� �`�r�.�, �>>> ; -��-��,,� �,_���� <br />State License Number Conlracl Price of Work <br />� <br />'. -� J� - <br />Proposed Use of Buildinc� Contacl Person fPlan Review) <br />Descrip�ionolWorkW6eDone: .�-'-'�'� �1„"�f� ���"��'`��{`�� ���'-i= �_�L��`�' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that 1 have read an <br />conecL AR provisions olla�vs and <br />whether speci(ed herein or noL T <br />violafe or cancel fhe provisions ol � <br />performance ol qAnstnic6on. Thal <br />work lor which �nplica6on is made <br />29G.200 WAC. i � <br />�'� � � � <br />eaamined fhis applicntion and know fhe same to be frue and <br />rrlinances goveming this type ol work will Ge complefed <br />a r�ranting ol a perrnd does nof rosume to gi��e aufhonty fo <br />iy ofher stafe or lo I law rec�uPting consVucho�i or fhe <br />arn airthoiized by he owner o/ Ih�s property to pedonn fhe <br />nd 1 comply edtli he State Contracfors Laiv iP,.27 RCW and <br />�`(��)�� <br />FEE <br />, ��_�GC� <br />}� . <br />