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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE'"- NA 98201 <br />425-257-8810 - FAX 425-257-8857 - v.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�: �- ��' r�1.=/ii � i fc0 �JG ��.i L C��2 c'7l w l4 9�j � �� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />PAail Address <br />Mail Address <br />City <br />Cily <br />State/Zip <br />Sla�e.'Zip <br />Phone <br />Phone <br />��ao�_n�, D.::.a�� Coti:, !�;< I'�; fi�,;� ii�7� rnul� �u�. `7f�27s <br />Eleclrical Coniraclor ldail Address City Slate/Zip Phone <br />�f 2� -33 0 .cls � f <br />Slate License Number <br />5 r-i: <br />Propused Use of E3uilding <br />Description o( Work to Be Dune: <br />NOTE: \NIRING 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 />Conttact Price of Work <br />Conlacl Person (Plan Review) <br />fEE <br />I herebvi ce�tily fhaf 1 have read and e,eaoiined this applicafion and kno�v lhe same fo be frue and /� �/J� i <br />cerrect: A/l provisions o/ la�vs and oidin�nces gove�mng Ihis type o( u�ork �vill be cornplefed ���l ��"� � �' �J <br />�rhether spea6ed herein or noL The c�rmifin� ol a pernuf does nof resurne to �ive aufhonty to <br />violate or cancel fhe `�ro��isions o/ any other sfate orlocal lau� rec�uPting consWc6on or Ihe <br />ivo k(or3�vh ch aco�l ctatior��'s n ��de and�l c�ohodzeQfh ff e Stale Confr'actors Lar�i 18.27 RCrW and <br />29G.200 INAC. P� � y <br />/ <br />'i^2�1�^% <br />