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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 & CREDIT CARDS ARE NOT ACCEPTED <br />I 0� U3 r�or�Tlr- ��A !-oT 2 <br />PROJECT ADDRFSS <br />��K��Ati� ��r�CS <br />Owner Mail Address Cily Stale2ip Phone <br />��T.�`�; C�%V�� <br />Tenant Mail Address City Slale/Zip Phone <br />;,� n,r� lT E�.CC1�-�c. 6"�3 2bist- 'ST N W S7A nit.xr;l c.�� -�i 62� rl- y ZS 3r�� 5�57 <br />Electrical Contractor Mai' Address Ciry Stale/Zip Phone <br />.Sc �MM I C 1 rno KZ <br />Stale License Number <br />�� � <br />Proposed Use o( Buildinc� <br />Description of Wurk to Be Dono: �.c� � F� �k% Sr I�— <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 />y Sou <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />FEE <br />1 hereby ceriily Ihaf 1 have read and examined tliis application and know !be sarne fo be frue and <br />conect. AO provisions o/ lmvs and ordinances �ovenung fhis type oI work will be completed <br />whefher speci6ed herein or not The c�rarting ol a pemuf does nof resume to give aufhonty to <br />violate or cancel Uie provisions oI any other state or local law reguPfing construction or the <br />performance oI construction. That I am authorized by the owner o/ fhis property to perfomi the <br />work lor �vhich applicafion is nmde and 1 compty with fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�i `zS -o s <br />� us� y -��? <br />