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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 95201 <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 �OT AC(.�PT�D <br />ci O � l �I�' (� I �C�_� S � <br />PROJECT ADDRESS <br />Jc�ke ��.�s-1-� c <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />Electrical Contractor " Mail <br />��C' 11��:��� C�g��l-1 S <br />State License Number <br />:'\C j � L� 6l �-� a_ A <br />Praposed Use af Building <br />Description of Work to Be Done: <br />�"%P lc� ce � <br />City <br />City <br />�K"�5� �S�;J <br />City <br />State2ip <br />1�-y <br />Phone <br />Phone <br />�I� 5 <br />`i� � � �„� <br />Slate2lp Phone <br />� �oJ� <br />ConVact Price of Work <br />Contact Person (Plan Review) <br />I�,s1-��-� �I � ���-1��-. i5� 1 � <<1 <br />) <br />� (��� > s,' � �j 1,v� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and exammed this applicafion and know fhe same to be true and <br />correct All p;ovisions ollaws and ordinances govem�ng this type oI work will be complefed <br />whether specilied herein or not The granting ol a permd does not presume to g�ve authonty tc <br />violate or cancel the provisions o(any other stafe or local law regulafing construction or the <br />peAormance eI const�uchon. That / am authomed by the owner oI th�s property to peAorm fhe <br />work lor which appiication is made and I comply with the State ContraUors Law 19.27 RCW and <br />296.200 WAC. / �I ��) <br />,-�-�- �� ,:l �.d?�-� _ , � o _ <br />�o�t��-�s� <br />