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ELECTRICAL PERMIT APPLICATION <br />CITY CF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvuw.everettwa.org <br />APP_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />/U//l ��pn�/'/�} �/a0 L...,— S <br />PROJECT ADDRESS <br />CatcLAn�� /fowr5 �r� ��• �'ox °ye �l�• Sr�✓rr+f �i&Z.SY y,.s-3Sc ��G1 <br />Owner Mail Address Cily Slale/Zip Phone <br />Tenanl <br />Electrical CoNraclor <br />State License Number <br />�/- !^�' <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Descriplion ot Work to Bo Done: �/�%' �Ci wLN... <br />NOTE: W'RING 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 />City <br />City <br />Stale/Zip <br />SlatelZip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />I hereby certify fhat 1 have read and examined this application and know fhe same to be frue and <br />correcL All provis�ons of /aws and ordinances governing this type ol work will be completed <br />whether specilied herein or noL The granting o/ a pernuf does not presume to give authonty fo <br />vio/ate or cancel the provisions ol any ofher state or local law regu/ating construction or the <br />perlormance o/ consfruction. That I am authonzed by the o�vner o! this property to peAorm fhe <br />work )or which application is made and 1 comply �vifh the Sfate Contractors Law 78.27 RCW and <br />296.200 WAC. <br />05 <br />Phone <br />Phone <br />2'' ��� <br />'U <br />� <br />