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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 />`> �� C �' ) `� �� � _._C <br />PROJECT ADDRESS <br />� Lf� �lYj ��.�i\i����ti `�SC� <br />Owner Mail Address <br />Tenanl <br />Eleclrical CoNraclor <br />Slate Licensc Number <br />Proposed Use of f3uildiny <br />Mail Address <br />Idail AJdress <br />Descriplion of Worh lo !3c Don��� � <br />� �� c° uenc,l.1 <br />Clly <br />Cily <br />Cily <br />'- ������4��c.4.� <br />I,�., n1 3 <br />NOTL: WIRING IN NOIJ-DW[LIINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� <br />c � ,� ,� G 3 <br />Stale/Zip <br />State/Zip <br />Sial��_ip <br />Contract Price of Work <br />�q.q � i <br />34y -��1 <br />Phonc � � I <br />Conlacl Person (Plan Review) <br />CITY OI= EVERE IT LOCAL SALES TAX CODE IS 3105 <br />I hereGp <'i�rtily thaf ! ha��c read cmd exnmined fhis applicafion and hnmv fhe sntt�e fo bo fruo end <br />connct. AIf provision� o! /airs and orAinances govennng fhis t}�pe oI worh irill be complefed <br />whefher speci6ed here�:! or;;�;. 7he nranting o! a pernuf does nol�>resume fo give aulhonty to <br />viola(e cr cancel fhe provisions oi any ofher sfate o� lucal lan� re�u nfing corsfrucf�on or fhe <br />pwfor�;iance o/ constn�ction. Thaf ! am aufhorized by the o•.rner o/ fhis property fo peifonn fhe <br />aor;� lor which application is made a:td 1 cornply �rifh thc Jfa(e Contractors Law 1U27 RCIV and <br />296.200 lh'AC. <br />, <br />I , <br />_ s�,���.,m��� <br />FEE <br />Phone <br />Phone <br />�; <br />—L l. ' C ' C, (� ��� � <br />