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,)-1 <br />ELECTRICAL PERMIT APPLICA�ION <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 B AM TO 4 PM <br />J <br />�L � � � <br />, � � ! I(� l <br />PROJECT AUDRESS <br />r�� L`' �� 0 �' i� rj C� 2� S�i � <br />Ownef <br />Tenanl <br />Lleclrical Contraclor <br />Stale License Numbcr <br />Mail Address <br />Mail Address <br />A1ail Address <br />�ity <br />City, <br />Ciry <br />Slate2ip <br />Slate/Zip <br />StatelZip <br />�OS�I �- ' �?� � <br />�' � �� <br />Phane <br />Phone <br />Phone <br />Conlract Pnce ot Work <br />Prop�sed Use of Building Conlact Person (Plan Review) <br />Description of Work to Be Done: � 1 W ��� ��� �l �"� � �/ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily Ihat I have read and ezamined fhis ap�'icafion and kno�r fhe same fo be t�ue and <br />correcf. All provisions o/ /a�vs and oroinances governing this t}�pe ol �voik will be cornpleted <br />whefher speci(ed herein or noL The �ranling ol a pemnf does nof resume to �ive aufhonty fo <br />violate or cancel the provisions ol any other state or local law reguPfing consfruction or fhe <br />pedormance oI consf�uchon. Thaf 1 am authorized by the owner o( tlus property fo perform the <br />work lor �vhicbapplication is made and 1 compty �vilh fhe Stale Contractors La�v 18.27 RCN� and <br />296200 W ` ,� % <br />�1*-;'� �i l.1 i �� � � <br />FEE <br />� o ���y-�, ��. <br />