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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 <br />�S � � /1� vn/ J�) .� � l/'�� <br />PROJECT ADDRESS <br />(� (/� L7 �? <br />� �J <br />Tenant <br />i/ <br />Electrical <br />Stale License Number <br />Proposed Usc of �uilding <br />Description of Work to Be Done: <br />��S/i <br />Mail Address <br />Mail �ddress <br />Atail �ddress <br />City <br />Cily <br />City <br />3' 'i�--./'7 / 9 J la�� ;�� ��{ l/ l � 7� ,� J ���� <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 <br />G/ G ���� =3��-3 y�S' <br />Slate2ip Phone <br />StatelZip Phone <br />State/Zip <br />Conlracl Price o( Work <br />Contact Person (Plan Review) <br />I hereby certily fh�t I have read and examined fhis applicafion and kno�r the sarne fo 6e true and <br />correcL All provisions o(laws and ordinances governrng fhis type of work will be completed <br />whefher specilicd herein or not The gianting ol a pernut does not reswne to give aufhonty to <br />violafe or cancel the prnvisions oI any olher sfate or local Imv reguPting construcf�on or fh� <br />perlormance o( construcfion. Thaf 1 am aufhorized by fhe owner o/this propeRy (o perform the <br />work (or u�hich application is made and 1 comply �ti�ith fhe Sfafe Contractors La�v 18.27 RCW and <br />FEE <br />,�i' j I/-�� �%/�—�7 <br />�l <br />Phonc <br />