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ELECTRICAL PERMIT APPLICe4TION <br />CITY OF EVERETT PERMIT SERVICES ,l,_' <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 />��'3 2,� �� �.� � � <br />PROJECT ADDRESS <br />TLl '���t �� <br />Ovmor <br />Tenant <br />Mall Addross <br />Mail Address <br />� Yt' k.� %� � i�-.�lT <br />City <br />Cily <br />State2lp <br />State2lp <br />Phone <br />Phona <br />�'����%, f' �'/�c1'r�'c 73l �5'��'�i S�.�L�w 5h�,.�w��t,.�rq-�l�'L9'L- — <br />Eleclrical Conlreclor Mail Addross Ciry Stale2ip ��D � n� Phone <br />�'lar� L--T6 3�'k'� <br />�l �� L 1� � <br />S�%ate Ucense Number Conlracl Price of Work <br />Proposed Use ol8uildfng <br />Description of Work to Do Dono: <br />���C� � � 11.� vL�o <br />NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />Conlact Person (Plan Review) <br />� <br />1 hereby ce�ti/y fhaf I have read nnd exdmined fliis applrr,a(ion anA know fho same fo be frue and <br />correct All provisions o(/aws and ordinances �ovemin� this fype of work will be completed <br />whether speci�eAherein or noL The granfing o!a perrnd does nol presume to give aufhonty to <br />violate or cance/ fhe provisions ol any other staN or local law regulating consfrucfion or fhe <br />perfonnance o/ constiucfion. Thot 1 am authoiized by the owner o/ fhis property to pedomi the <br />�vork lor �vhich application is rnaAe and 1 compty �vifb (he Sfate Confracfors Law 18.27 RC W and <br />29G.200 WAC. <br />� 1�=2��G <br />FEE <br />r L��� r� <br />�� �; C�) <br />