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ELECTRICAL PERNIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES � a_� s-O�< <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -www.everettwa.org � ��/� �O� a <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�=> 1 � l<� U� i ��,��� ��Y-� <br />PROJECT ADDRESS <br />Owner <br />��) f � � � �{- ��Ol��n <br />Tenart <br />Electrical Contractor <br />State License Number <br />Proposed Use of �uilding <br />b�� I-ct��sa �l� c��ti� �����e� <br />Mail Address <br />, <br />� ��` �� Ol �a��_ 5�%If�, �1! <br />Mail A�dress <br />Mail AdCreSs <br />City State/Zip <br />�}1'1�,Y'P �U� ir�l_ IIJI� <br />f,ity <br />City <br />StatelZip <br />State2ip <br />Contract Price of Work <br />(���� <br />�(�3 ��� i��bL�Z� <br />Phone <br />(� Z� �j <br />Phone <br />Phone <br />Contact Person (Plan Review) <br />Description of Work to Be Done: � I'� `� �� i�� j�1 �1 I(�� �' 1 I�C �' l� �7G� �' C�-l� E'-�� � <br />NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IG 1105 <br />I hereby certify that 1 have read and exammed this apolicaticn and know the same :o be true and <br />correcL All provisions ot laws and ordinances guvemrng tNs type e( werK �vill be comple(ed <br />wnether specdied herem or noL The granting o/ a permd dces nct presume to grcr authonty to <br />wo!ate er c�ncel the provisions ol any other state cr;ocal law regulahng construction or the <br />Ue�iormance oI con5lrucLon. That I am authonzed by (he o�sner o/ fh�s prnpeRy to perferm fhe <br />�verk /or wh2h applic�ticn is made and I ccmply �vdh the Sta(e Centractors Law 78.27 RCW and <br />296.200 WAC. I <br />iI � . � <br />���1.�i ( �I if' (� �� �,; <br />���' ��1 ��"�� <br />�; <br />FEE <br />' i _� - /�� <br />c�%/ <br />