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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.ever�ttwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - �EBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�fl�DO S �-l��- Av� <br />PROJECT ADDRESS <br />��RLI<�/Z� Vi4NGE S/-�ME CV( G/4 �U7�� /2c�1y59zf3�� <br />Owner Mail ACdress City SlatelZip Phone <br />Tenant <br />Eiectrical Contractor <br />Licr:nse Numl•er <br />(ZE S I'D `cnJ �7 Iq L, <br />Proposed Use of Building <br />A1ail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />Slate�Zip <br />Contract Price of Work <br />Contad Person (Plan Revie�v) <br />Phone <br />Phcne <br />Description of Work to Be Done: I� S I L� L L 12� A,t )�-� C l-�OCi7 ��D��J �'i l.) �C �C�2 <br />NGTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, R1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and ezamined this application and kne�v the same tu be We and <br />crrrect. All provisicns ollaws and ordinances governmg this type et work �vdl be complefed <br />�rhether speci6ed herein or not. ihe granting o/ a permrt does nct presume to give authonty to <br />�✓�clate or cancel the provisions o/any other siafe er local la�v regulafing ccnstrucfion or ihe <br />pertormance u( consfruchon. That 1 am aulhonzed b;� the owner e( th,is property to pedorm the <br />��vcrk for which application is made and 1 comply wdh the State Contraciors Law 18.27 RCW and <br />296.200 WAC. <br />2•22•OS <br />FEE <br />� <br />L� �-���L /�I <br />