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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 8 CREDIT CARDS ARE NOT ACCEPTED <br />�71�� i1L�DUCAL <br />PROJECT ADDRESS <br />I�{ �� t'1 <br />owner <br />� <br />, : �.nant <br />CCN S ;r«C�lc,� <br />Mail Address <br />Mail Address <br />�ZiJ7 7y �--At� 1�.� <br />City <br />Cily <br />�'iC �t=���-`�'Zl C�U�C P o. Cx�n 3.5`� SNc�i.�ncSti <br />Glectrical Canlraclor Mail Address City <br />'� �'I C E(:� c,l� � 3 � F <br />State License Number <br />%;.�f` <br />Proposed Use ol Buildinc� <br />Descriplion oI Work �0 6c Done: �`-' �z ��, r I� <br />`' .�'f�V l CF <br />NOT[: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />S �. � <br />NAR�/SdiICF ��A 9Pz�o <br />Slale/Zip <br />�h SS2`i 1 <br />si���iz�P <br />Contract Price of Work <br />Phone <br />Phone <br />�� -5�s�s-�ss <br />Phone <br />Contacl Person (Plan Review) <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br />/ he�eby certily Uiaf I have read and examined fhis application anA kno�v fhe sarne fo be trae dnA <br />conecG All provisions ollaws and o�dinances c�overmng Ihis type o/ u�ork wi!! Ue complefed <br />whelher specified herein or noL The �ranfing ola pernul does nof esume l0 9ive aulhonty (o <br />violate or cancel ;he provisions ol any other state or local law re�uPa(ing constriiction or the <br />perforrnance o/ consln�clion. Thaf 15m aufhorized 6y fhe owner o/ lhis property to pe�form ffre <br />�rerk lor u�hich applicafion is rnade and 1 compty �vifh the State Contractors Law 18.27 RCW and <br />296.20 WAC. ` <br />i 7 � <br />----� f � �� �'. C�/ �, � � � - <br />! � —l_ A � � � � ��--- �y <br />5ignatwe <br />Zcr� <1�{P �.1 �� �-�'i d� <br />FEE <br />