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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 />5—�l �oS <br />� O SD 5 �O� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />3122 � uc.k E2 Qv� <br />PROJECT ADDRESS <br />Tenant <br />Electncal Contractor <br />��o�InE2 i�oP�l <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Mail Address <br />City <br />City <br />Description of Workto Be Done: ` l�}�1POPAf�Y_, . �✓1 t <br />NOTE: V1'IRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />SlateZp <br />StateZp <br />Stale/ZJp <br />ConUact Price of Woric <br />Contact Person (Plan Review) <br />I hereby certily fhat 1 have read and examined fhis applicafion and know fhe same fo 6e true and <br />correct. All provisions ol/aws and ordinances goveming Ihis type o/ work will be completed <br />whether speci�ed herein or noG 7'he granfing ol a permd does not presume ro give aufhonty to <br />Nolate or cancel the provisions ol any other state or local law regulafing construction or the <br />peAonnance o/ construcfion. That I am authonzed by the owner o! th�s property lo paAorm the <br />worA Io� which application is made and I comply with the Slate Conlractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />��500 <br />E l:`SC:'� � c � iV <br />Phone <br />Phone <br />Phone <br />