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ELECTRIC,4L 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 ACCEP'ED FROM 8 AM TO 4 PM <br />'� � � <br />� <br />� rf �� l�C� /; C aC l i•7 / <br />PROJECT ADDRESS <br />���'��/f� /�0//°i✓ <br />Owner <br />Tenanl <br />, 1�,� � <br />Eleclrical ConUaclor <br />Lir,ense Number <br />Proposed Use o( Duilding <br />> rl �r <br />A1ail Address <br />Mall Address <br />Mzil Address <br />Cily <br />City <br />Ciry <br />Descriplion o( Work to L�e Done: �'�� �- �" �j -� �� j'" <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />C <br />�-;c� 7�'�-5� <br />StatelZip <br />StatelZip <br />Slate/Zip <br />Conlracl Price o( Work <br />Conlacl Person (Plan Review) <br />�,.' 1 G -[' <br />I hereby ceriily Ih?f I havc reod and examined Ihis application and hne�r the same fo be fnie and <br />conect. All provisions olluws :�nd ordinmices govenung fhis type oI �roik will Ue cornpleted <br />whefher specdied herein or nnL The grantinc� o/a pernut does net presurne to give authenty to <br />violafe or cancel fhe novisions of any olher st3(C OI IOC7I I815' fB(Jlllafing consVuc6on or fhe <br />peifamiance o/cons��ucfion. Thaf 1 am aufhorizeA by fhe o�ti�ner o! fhis pioperty fo pe�forrn Ihe <br />�vork /or �.hich applicahon is made and 1 comply with the State Contractors Law 1827 RCW and <br />29G.200 WAC. <br />jL''��i—�i L� <br />FEE <br />C�,�. �C' �R�i <br />Phone <br />Phc�e <br />Phone <br />S <br />