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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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� <br />3l o� 6,tsi r�G���TL <br />PROJECT ADDRESS <br />/�L,-�„/ L�: ,�.z,,, � 3�z� ; ��1.-��,r. ��� r� ,�,��� � w,�- 9�. �z���3 <br />Owner Mail Address Ciry State/Zip Phone <br />Tenant <br />Mail Address <br />Clry <br />Slate/Zip Phone <br />� I <br />i / <br />Lc.v�nl/tt<'[li3'�-/�'(.f���r'I i n'iK.T�ci� �.O.r���( /1� nii .1�3�2«1C�sJ LJir g�G%� <br />Electrical COnhactor Mail Address City State2ip 'hone <br />��,�r,�rr-� d 9c� i L 5 <br />State License Number <br />UFri��� �K�%r,�'r`rrL /jv� s . <br />Proposed Use f Building <br />Description of Work to Be Done: �""`� v��. ���7 �L rt �ei 1%���9��-r'r <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 />% %�Js, n l� <br />Contract Price of Work <br />�rs, ✓ l�✓��,� ,— i, e.sGL <br />Contact Person (Plan Review) <br />(3i�o) SYES—�3"33 <br />1 hereby certi; v that I have read and examined this application and know the same to be true and <br />correct. Aq provisions o(laws and ordinances govemm� thrs type ol work will be comp/eted <br />whe(her speci6ed herein nr not. The granting ol a permd does not presume to give aufhonty to <br />violate or cance/ the provisions ol any other state or local !aw regulating construchon or the <br />performance ol construchon. That I am authonzed by the owner o( this propeRy to perform the <br />Gverk /or ivhich applicalion is made and 1 comply wdh the State Contractors Law 78.27 RCW and <br />296.20p�WAC. , <br />�'� Z � — C`i 5 <br />FEE <br />,�,7'' / - ��%� <br />