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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 — w�nvd.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �� /—� JG <br />.� %� � SEA l� �f��T A U �� l��i,� Z <br />PROJECT ADDRESS <br />.l�(� <br />Owner <br />Tenanl <br />� a�s-���"^�1„e,vE <br />i� ��o �.S �� S�i.��l�vr,� � 5� <br />Mail Address <br />Cily <br />� � �— <br />MailAddress �., '�•' City <br />3ya�1. �ti i�,,E ;�-.- <br />�r�� �o � i 5 5 �- � �, � -��1R�-(�- <br />Electrical CoNraclor Maii Address <br />�,-G �i::� �-et-G�4��' <br />Stale Lir.ense Number <br />5�=�'� <br />Proposed Use of Duilding <br />City <br />yb 2`i�' <br />Gi,G}`. <br />SIatNZip <br />Sl�telZip <br />Z5"• LI B-U41 O <br />Phone <br />Phone <br />� <br />��rr , lU5 1:$S�`� q�-3�4-5 <br />State2ip Phone <br />� � L U��. <br />Conlract Price of Work <br />Descriplion of Work lo [3c Done: _ l��� � z U J �/� �1'� � <br />NOTE WI41NG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Conlact Person (Plan Review) <br />5�r� zt— <br />FEE <br />f `�`� <br />i � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily Ihat I have read and ea�amined fhis applicafion and kno�v fhe same fo be true and <br />correcL All provisiorrs olla�vs and ordinances governing fhis type ol u�ork will Ge campleted <br />whether specilied hea�in or noL The granfing ol a permrt Aecs nof presume lo give aufhority fo <br />violn(e or cancel fl�e provisions o/ any other sfafe or local law regulating consfruclion or the <br />perlormance o! c�/ istrucl�on.�T hal 1 �nyyy aulhorized by fhe owr�er ollhis propeAy to perlorm fhe <br />work lor �vhicfi a4SS�lication iS�,rlade a/Iq I comply �vith the State Contractors Law 18.27 RCW and <br />296.200 WACI ��--- l 1 // i I <br />i /vs� <br />Ec5r9 -cvy <br />