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�LECTRICAL PERM{T APPLICATION <br />C(TY 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 6 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />— i <br />�� (i`l - t�Jt' <br />PROJECT ADDRESS <br />..l t�\�c - <br />C�vner <br />5�i����- <br />Tenant <br />Maii Address <br />Mail Address <br />State Zip <br />State2ip <br />Fhone <br />Phone <br />'.( _"i���'-;' l��L"��I I� ��4' ���"i': '>�_�Pil '�}.�. `Ic'�i��C C.���t. ( �I�. �j��SZ .j'i. :'i-G <br />Electrical Contrector Mail Address City State2ip Phone <br />i:t /�LKc-. �L IL•G .L? Z <br />State License Num6er <br />� <br />;��7 -f.,�,,/� <br />Proposed Use of B�ilding <br />�escription of Work to Be Donc: l.i�� r�c.°� %�'!`it <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITI' OF EVERETT LOCAL SALES TAJ( CO�E IS 3105 <br />`�7C- �- <br />Contract Price of Work <br />Con:act Person (Plan Review) <br /><..;. ,... tc <br />I hereby ceRily that 1 have read and examined this application and know the same to be true and <br />c^rrecL All provisions o/laH�s and ordinances goveming this type ol work will be complefed <br />whether specilied herein or not. The granfing ol a permrt does not presume to give authonty to <br />violate or „zncel fhe provisions ol any ofher state or loca� law regulating construction or the <br />,;e.�formar,c: o/construchon. That 1 am au[honzed by the owner o/ fhis property to pedorm the <br />wcrk Ior �vhich application is made and / comply wdh the Sfate Contractors Law 18.27 RCW and <br />296.200 �'✓AC. , <br />� � — <br />; . ;, _-t��"� /J _ i- � ,% ., <br />FEE <br />� � ��:� �-5} <br />