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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��? b'J� W�•�,�,o,-�- su, % 3ov <br />PROJECT ADDRESS <br />Owner Mail Address City <br />Stale/Zip Phone <br />V/Si ��1G �VU-�� SNi�/��C/S <br />Tenant Mail AAdress City Slate2ip Phone <br />La / <br />Electrical CoNractor Mail Addmss <br />l( C,�'r TfZ ly y�P <br />Slale License Number <br />�� rr;�.� <br />Proposed Usc of Building <br />Slate2ip <br />� S�1S <br />Contracl Pricc of Work <br />ki.�5 J�ryi�yr� <br />Conlact Person (flan Review) <br />Oescrip�ion of Work to Be Done: ./1 �/� 7v p., 'f l� �5 u-��.� n N. s�- e�.,.� -�.. <br />o�rs�lt Yu- �.�+�on Pc-�lz.'1.- C�u.-� r,- <br />NOTE: WIRING IN NON-DWELLINGS IS RE4UIRED TO FEE <br />BE IN RAC[WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 here6y ce�ti/y fha( f have read and examined this applicafion and know the same to be tnie and <br />correcL All provisions ollaws and orAinances govermng Ihis type ol �vork will be completed <br />whefher speciGed herein or not. The granting o/ a pernnf does not preu .vie to give authonty to <br />violate or cancel the provisions oI any ofher sfafe or local la�v regulafing construction or the <br />pedormance oI consf�uclion. Tlraf I am aufhorized by fhe owner o/ this prope�ty to perlomi the <br />work lor which applicafion is ntade and I comply �vith ihe Stafe Contractors Law 18.27 RCW and <br />296200 Ih�AC. <br />�.,...r� �/1 s/o s" <br />Phone <br />