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ELECTRICAL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEP,ETT WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� �(` <br />;.70�1 1<Cc��l-Gl�c�� %-_.0 <br />PROJECT ADDRESS <br />, <br />�.7{�4't �..1,�:_'�. C-.'« (�:r lit(-�U�.y- �<� �wrc7y �L.L ��(?r3 42S 3llFS'�61G <br />Owner Mail Add« ss Ciry State2ip Phone <br />Tenant <br />Mail Address <br />Ci�y <br />SlatelZip <br />Phone <br />` KF.ST� v�`ti'12� c 7",n� ?_Z ?c .Ac�e,�•• S y�.,-a G v��C�e.'�Y WA �?i�',•-G3 t{? S 2�t d- i6 �d <br />EleCtrical ContraClor Mail Address City State/Zip Phone <br />rZ�s�e.� 9�3c� <br />Stale License Number <br />`�.f � <br />Pronosed Use o( Building <br />I`i�t �. �. <br />Contmcl Pnce of Work <br />Conlact Person (Plan Review) <br />Description o( Work to Be Done: �? Of� A j= -�Sr- -- ( ,�r �� � ro �,i V� Zc k}S <br />NOTE: WIRING IN NGN-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR P.0 CABLE. <br />CITY OF EVERETT LOCAL SALES TAh CODE IS 3105 <br />1 hercuy certily fhaf 1 have read and ei:amined fhis applicalion and know Ihe same fo be fn�e and <br />cone� ' All provisions o/la�vs and ordinances govemm� fhis type o( woik will be complefed <br />wheth� specilied herein or noL The r�ranfing of a pernuf does not resume fc give aufhonty to <br />violate or cancel Ihe provisions oI any other stafe orlocal law reguPting consVucGon or Ihe <br />performance ot censfruc6on. That I am authorized by fhe o�vner o/ this property to perfonn fhe <br />�: o�k Ior which applicatien is made and 1 comply wilh the Sfate Contractors Law 1�27 RCIY and <br />296.200 WAC. <br />h� <br />FEE <br />�C�Q�(-ZCO <br />