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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERM�T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 �- FAX 425-257-8857 — ww�n�.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�81 D /l%c.Ssaa-� <br />PROJECT ADDRESS <br />/V--J� <br />Ov+ner <br />Tenanl <br />C���Nc/� <br />Electrical Contraclor <br />/�<zd�Si . <br />Atail Adtlress <br />A1ail Adtlress <br />�dai1 Address <br />C�uFcN�?�79�}i 3�' _ <br />Stale License Number � <br />a : a��J le�cGi�, Pu,/��.� <br />Proposed Use of Building —7 <br />Descriplion of Work lo Be Done: <br />NOT[ WIRING IN NOIJ•DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CADLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />C�ty <br />E (/ol-O(5 <br />Ui� �'�020/ <br />SI:�'e/Zip <br />Slale2�p <br />Slate/Ziu <br />Phone <br />P�ione <br />Phone <br />�700 °�' <br />Contract Price ol l4�ork <br />�'�nn (7cr;alc+.���-396-97�i) <br />Contacl Person (Plan Review) <br />1 hereby ceRily that I have �ead and exarnined fhis applicafion and kno�v Ihe sanm (o be truu and <br />cortect. All provisions ollaws and ordmances gcveming fhis lype of work �vill be corr.aleted <br />�vhefher specified herein or noL The granfing o/ a pemu( does nof prasume fo give authority to <br />wolate or cancei Ihe provisions o! any olher sfafe or lecal la�v regulnfing consfrucfion a fhe <br />peAormance oI conslrudion That 1 am aullrorized by fhe o�:ner o! Ihis property lo pedwm fhe <br />�vork lor �vhich application is rpade and ! ygmpty �vith the Sfate Contractors Law 18 27 RCW and <br />FEE <br />