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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 />g,.g1-o5 <br />�=p$,p�-1 � 3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - OEBIT 8. CREDIT CARDS ARE NOT ACCEPTED <br />111� 3 c,� M v�� i ��Q ��V1� <br />PROJECT ADDRESS <br />�/ZS <br />%�// <br />%2GN L3(/L() //�3 l.�J.Muf.cl c,7X'G l3LV� f7(�N6�% S'�•�?.5 <br />Owne� Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />Fz�"L�ndl�ht� S � S 3�� <br />Electrical Contraclor Maii nddress <br />�1--1�lM<<f /y 1 Ll� <br />State License Number <br />SF�I,' <br />Proposed Use of <br />City <br />Ciry <br />State/Zip <br />Ccatract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: AI� I�P . /i KL %C PT�'G� � L ��.ST�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 />I hereby ceRity that 1 have read and examinnd this application and know the same to be true and <br />correct. All provisions o/ laws and ordinancc�: qovemmg fhis type of work wdl oe completed <br />wnether spea6ed herein or noL The granting o/a pe�md does not resume to give authonty to <br />violate or cancel the provisions o( any other state or local law reguPting conswchon �r the <br />pedormance o! construct�on. That f am authonzed by the owner of this property ro pe, lorm the <br />work for which application is made and 1 comply with the Sfate Cuntractors Law 58.27 RCW and <br />296.200 WAC. <br />/ <br />FEE <br />35°� <br />� ehone <br />�( ��l <br />�os�� -�Z3 <br />Phone <br />