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ELECiRICAL PERMIT APPLICATIQN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-6857—www.everetlwa.org � ���g,Q(� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />r <br />/,1�.� ���i�(i�;l�A. /t -��, <br />PROJECT ADDRESS <br />('L`%( l�'� <br />Owner <br />Tenant <br />� I ' ��) � � �'�. l. � � R l; < <- � , T <br />Mail Address <br />Mail Address <br />CAy <br />City <br />i �� ri <br />SIale2ip <br />State2ip <br />Phonc <br />Pl�one <br />/1 <br />C�il�Dth.-tC-P��_����thc: �Ck�'� l��'M/�tivA� /�r7�Gla,�,�a Lv�4-� ���%��-'� �f�i-5����� �i�1� <br />EIceMC21 Contraelor Mall AOdrtiss City State2ip Phone <br />C'!� r'i-( �i `l,� C G+iC� <br />State License Number <br />Pro{wsed Use of Building <br />� <br />Description of Work lo Be Done: �-� �!-> ' � ` � � �' `� '� • • � �' �'" <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 />1 hereby certify that I have read and examined this apPlice <br />cormcL All provisions ollaws anA orAinances governing i <br />v�hether specilied herein or noL The gran!ing oI a permrt <br />v�olate or cancel fhe provisions o� any other sfafe or local <br />peAormance ol consWchon. Thaf 1 am aidhonzed by the <br />work lor wh�ch applicafion is rngde and 1 comply wdh tbe • <br />296.200 WAC. / /� <br />„ / <br />''j. �_ <br />� _ <br />," !�� ";yl,-� <br />��L�� �� <br />Contract Price of Work <br />Contact Person (Plen Review) <br />and hnow fhe same Io be (rue ard <br />ppe cl work will be complefed <br />�� nol msume to qive authonty lo <br />aguPhng construction or the <br />er o/(his property fo pedorm Ihe <br />Cnnhactors Law 1H27 RCW and <br />�rlr`�/c <br />�; l I��� �� l l <br />FEE <br />