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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CF.DAR 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 />�Z�C ��,.�t�L�l�l"1 -�\�C <br />PROJECT ADDRESS <br />�1;,1,�-1i- �` I, � � _ <br />o��ne� r.,.,�i t�ddre.. <br />Cd� <br />a _a-o -��' <br />C—oqo a-o9a <br />State'Z�p Phone <br />Tenanl I.ta�d �ddress City Stot�'7ip Phcne <br />��1 �) <br />.+l 2 n�,� <br />t�ZC ���c-h���� 2�ZZ �c+cicEi��r�� ���z C� U-,(� �1�� ��o�_�: <br />Eleclrical Conlraclor hlail Address City State/Zip Phonc <br />� E'-C l" I_ ,+-�- �1'luc t,- <br />State License Number <br />�U�n���< �lc-Y'L�i�l.� C�-l7�'��I�LC'� <br />Propased se of Buildin9 <br />S '.SC.�J r � <br />Contract Price of Work <br />�,� �CCYc CY i1� a. �Ntc� i��'t� <br />Conlact Person (Plan Revietv) <br />Descriptian of Worh to Be Done: I' �: �."�O� �� �-� ic� l fu� ��'1 A � S ��-� c!E �1 �I ��� �� 1�v, c��ar (��t`7 <br />1 <br />NOTE: WIRING IN NON-DWELI_INGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />y coAilV fhaf 1 have read and examined fbis applicafian and kno�v (he sarne fo be We and <br />. A I piovisions ollaws and ordinances governmg Ihis type ol �roik �rill be cempleted <br />�r specilied herein or not Thc gianting o/ a pemut docs nol presume fo give aufhonty fo <br />or ca^ccl the provisicns o/any other slafe or local la�v reoidafing constructwn or the <br />�ianca c/ const�uchon. That I am aulhorized by the o�vnei olthis p�opetly to perform fhe <br />�r which applic � on is made and 1 comply u�ith fhe Slafe Contracfors Law 18.2? RC W and <br />0 WAC � <br />`�C.� �- _ 2 - 2v `� <br />�� <br />FEE <br />