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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 8 CREDIT CARDS ARE NOT ACCEPTED <br />�U I� rn(j�Cr�rJ �_G I rL <br />PROJECT ADDRESS <br />�� ���K I��� �� <br />Owner Mail Address City State2ip Phone <br />�enant <br />Maii Address <br />City <br />StatelZip <br />Phone <br />��tJf ,��C�l� `l� EI,ECiI�� ( I lJ�� �����5 2C�� ;i- j"1- P� u1 JTf�IJ �CY�1j (;,�J� � `� i%1 `Z- <br />Elecirical Contraclor Mail Address City State2ip �` ��� � Son�„ <br />% j <br />`t lrn �n I C I nC�O ��� �, �� 5nU <br />State License Number Contract Price cf Work <br />� '� <br />._� �— �L. <br />Proposed Use of Buildinc� <br />Contact Person (Plan Review) <br />Descriplion o( Work lo Be Done: �-ti �� �'� �.�'� �r' L n(.1�U /�Ptlj� j[ �U IL(-' <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 />1 hereby certi/y fhat 1 have mad and examined fhis applicafion and know Ihe same fo be true and <br />correcL All provisions ol laws and ordinnnces c�overnuig fhis type ol work will be completed <br />whelher specdied herein or noG The r�ranting o/ a pennd does nof presume to give aulhonty to <br />violate or cancel lhe provisions o/ any other sfafe or local la�v regu/ating construction or the <br />pe�formance o/ constniction. Thaf I am authonzed by the owner oI this properfy to perfonr the <br />work /or which application is made and I comply wifh fhe Sfate Co itractors Law 18.27 RCIN and <br />29G.200 WAC. <br />FEE <br />�J - <br />r � �� <br />''' �- \ <br />—�__ ^j - �j (J � � <br />Si�nature Dale � /` , <br />'� V <br />