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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 />PROJECT ADDRESS <br />Otvner <br />Tenant <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � Z, � 7_ �' '� <br />M �� K <br />Atai Address <br />A1ail Address <br />f) � C-' 1) <br />Cily <br />Ci�y <br />Slaleilip <br />Slate�Zip <br />i=C�?/�-G'S�S <br />Phone <br />Phone <br />t�as.S: s' �'%c�'ric �3�'C> 5 I1� �� ,^,v�' / ct �� lr�� ��� �1 S Z�-� <br />Electrical Conlractor A9ail Address -E',ity State/Zip Phone <br />,In � <br />��GCL�f_12L'� �� �Q S ' n �i��� � <br />Slale License Number �`'I I Contract Price of Work <br />Proposed Usc ot Building <br />Description of Work to Be Done: <br />��/ I� �� /���� L.� � <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 />Contacl Person (Plan Revie�v) <br />1 he�eby certily that 1 have read and examined fhis applicafion and kno�v fhe same fo be Vue and <br />correcL All prowsions o( laws and ordinances �overmng this type ol work �vill be conrpleted <br />�vhether specilied herein or noL The grantin� o! a pennd doec notp resmne 10 give aufhonty fo <br />i�io/afe or cancel the �rovisions olany other stafe or local law iegulating consl�uc6on or the <br />pe�lorrnance o/ consfruction. That 1 am autho�ized by the owner o/ this preperiy to peAonn fhe <br />�vork /or which applicntion is made and I compty �rifh the Sfafe Contractors La�v 18.27 RCW and <br />29G.200 WAC. <br />—�'— — — / <br />�. . � �// � G/, � <br />FEE <br />