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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 <br />53�a �o�l����ccer flv�. <br />PROJECT ADDRESS <br />Plt-1,t,L�— =�1o►'nf��o/1 �Ilv�a �eah.c.c��-I� �ve- Ever��c- <br />Owner MailAtltlress C�ty SlatelZip Phone <br />Tenanl Mail Address City StalelZip Phone <br />PerFovmcznc�. dec�� ��30� agancL �� �Ju� �a.nwoocl 48a9a was-�sv- <br />Elec�rical Conlractor Mail Address City SIa�e2p Pnone <br />P�Fo�� GiqoS <br />State License Number Contract Price of Work <br />Use of Buiidmg <br />Description ol Work to Be Oone: <br />Contacl Person (Plan Review) <br />NOTc: WIRING IN NON-DWELLINGS IS REQUIP.ED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. f� O� <br />.:J <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � — <br />I hemby certily Ihat I have iead and examined Ihis applicafion and know the same lo be Irue and ��[J 0 I( _ I�/ <br />correcf All pmvisrons ol laws and ordinances goveming fhis type ol work wdl be complefed l �T� (P <br />whefher spc•cdied herem or noL The granling ol a peimd does nof presume io givo aufhority fo <br />violale o� cancel fhe prov�sions ol any otheisfafe or locallaw reyu/atmg consfrucfiort orthe <br />pedwmanr.e o� construcfion Thaf I am authorized by the owner o/ fhis propedy fo peAorm Ihe <br />wo�k for �vhich application is made and 1 compty wifb the State Conlraclors Law 78.27 RCW and <br />296.200 WAC. <br />D /vl h//a 5 , <br />� <br />