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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 />(c�/�� Ct) ;�'n-172F. �Ut� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />uSS��J E <br />rical Contractor <br />hlail Addmss <br />Mail Address <br />A1ai1 qddress <br />��SF.a_ I �3 � U <br />Slale License Number <br />�hF S�c�c�:�<4. <br />Proposed Use of �uildiny <br />City <br />Clty <br />Cily <br />Slate2ip <br />State/Zip <br />Slate/Zip <br />Conlracl Price of Work <br />Contact Person (PI2n Review) <br />i <br />Descrip�ion of Work to Be Oone; y- {7 �G C�C ,.�.r.c..,.�` r'�f `7c1'� A 7['�r� 1 r�' <br />c <br />NOTE: WIR�NG IN NON-UWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerlily Ihaf I ha��e read and examined fhis application and know the sarne fo 6e true and <br />correcL All provisiens ol lan�s and ordinances govemmg this type o/ work will be completed <br />whe0ier specilied heiein or not The granfing o/ a pemut does not presume fo give authonty to <br />violate or cance/ the provisions o/ any other state or loca/ law regu/efing consfrucfion or the <br />perfonnnnce ol conshuchon. That I am auihonzed by fhe o�vner ol this property fo pedonn fhe <br />work Ior which application is rnade and 1 comply with fhe Slafe Confracfors Law 18.27 RCW and <br />296.200 11�AC. <br />� r. � <br />. ���, -��-- � , <br />@t�1'IL' <br />Phone <br />Phone <br />Phone <br />FEE <br />� � <br />`7� <br />