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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 & CREDIT CARDS ARE NOT ACCEPTED <br />�n� °`� <br />_ I ��� r�0�'� �CIA I�D Gc�: / <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical <br />IL ��Y-f�j . l UrJ � <br />htail Address <br />Mail Address <br />�.t:�i'��, (�zo3 <br />Mail Address <br /><,�,�,r� ICi o�n�'Z <br />State License Numher <br />�J� P t,C�l <br />Proposed Use of Building <br />City <br />City <br />ST J� W <br />Ciry <br />Oescription o( Work to Be Done: l�-J f��- 1J E� i',,ri� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABI.E. <br />SWte2ip <br />SlateiZip <br />Slate/Zip <br />Phone <br />Phone <br />4 ZS � 6 <br />�j'L g�`. <br />Phone <br />�h�0 <br />Contract Price of Work <br />Contact Person (Pian Review) <br />`�-u� �rr�� `-.��1K..� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y that 1 have read and examined this appfication and know the same to be true and <br />r,orrect. A/l provisions o7laws and ordinances goveming this type o( �vork will be completed <br />�vhetl�er specified herein or nct. The granting o/ a permrt does not presume to give authonty to <br />violate or cancel the provisions o(any other state or local la�v regulating constrochon or the <br />periormance oI construcLon. That I am authorized by the owner of this property fo perform the <br />work for which applica�ion is made and 1 comp/y wdh fhe Slate ConVactors Law 18.27 RCW and <br />296.200 WAC. <br />S' `r n <br />