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% <br />ELECTRICAL PERMIT APPLICATIO�E <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDA.R STRE[T, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.or� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 7 i " C) i i'„ � f' �� L�� <br />ROJECT ADDRESS � <br />n � /� ,� �t j�� N�,(! �i. l ij � H <br />��^;;,r,,.�, �,;.:-r;,- <br />Owner hlail Address <br />Tenanl <br />�� V�/ I� �= f <br />Electrical CoNractor <br />Stato License Numbcr <br />S �''-I /�� % • % <br />Proposed Use oUBuildmg <br />Descriplion o( Work lo �o Done: <br />hlail Address <br />Mail Address <br />, <br />t ��� �; <br />Clry <br />Cily <br />Cily <br />R /Yc�� �'�; <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACFWAYS, MC OR AC CABLE. <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />Y� � �,� y�-c�y <br />�,. <br />_� � �� ,q (1 �i'�L ( <br />r � <br />Slale2lp Phone <br />Slale/Zip Phane <br />Slate/Zip Pnone <br />15�0 ��� <br />Contracl Price of Work <br />����',t T G� iV <br />Contacl Person (Plan Review) <br />1 hereby ceriily fhaf I liave mad and esantined tl:is applicafion and kno�r the samo to bo Uue and <br />correcL All p�owsicns o//a�vs and erdinances �oveirung fhis typc� o( work will be complefed <br />�vhefher specdicd heiein ornoL The c�ranting oI a perrnd does net ueswno fo gi��e aulhonty to <br />vielate or cancel Uie provisions o(any other state orlocal la�v re�u�afin� consfructron or Ihe <br />performance o/ construcfion. Thal I am aufhorired by fhe o�vner ollhis property fo perlorrn fhe <br />�vork lor rehich application is nmde and I comp/y �rith fhe Slafe Confracfors Law 7827 RCW and <br />29G20C WAC. <br />f ,% � P �, _.� �f' , h ' /� /,2-- <br />FEE <br />7 �U� <br />�'�,'U120y-�;0� <br />