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3�I 2 � <br />PROJECT ADDRESS <br />J � �'1 <br />o,mer <br />Tenanl <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org � _�C, _p'� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P�d <br />w� � w�o�F �v� � <br />��� T���s <br />Idail Address <br />M11ail Address <br />Ciiy <br />Cip <br />J�- �- ! C�(�50�1: G�i��%%(L �nl� <br />EleCtrical ConlraClor hiail Add�ess Clty <br />��l-��1 riD(��C= <br />Slate Licensc Nur�ibcr <br />C o,tl f�l� <br />Proposed Cse of �uildin� <br />Descri; Gon of Work to �c Done: � r�C __ ���"-� _� Jn/'�0 — <br />NOTE: WIRIIJG IN NOIJ-DWELLINGS IS REQUIRED i'O <br />DE IN RACEWAYS, Ia1C OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />State2ip <br />Slatc2ip <br />� <br />S uCv <br />Conlrecl Price of \1'orF: <br />Co7o6-09� <br />Conlact Person (Plan Review) <br />Oa .9w� <br />1 hereby certily fhat 1 have read mtd exnmined Ihis application and kne�r fhe same to be frue and <br />correc(. All prot�isions o�laws anAorUinonces governuia fhis fypo el work will bo comp/efed <br />whefherspeaGeAherein ornoL The granfing ol n permd does not �resume fo give aufhonq� to <br />��iolafe or cancd the I�ro��isions ol ony ofher state or loca/ la�r regulafirg construction or fhe <br />performance o( consfn¢fion. That I arn aufhorized by fhe o�rner o/ this property to perlonn the <br />work lor which applicafion is modo and 1 cornply irifh fhe Stafe Contii3ctors Law 1827 RClNand <br />29�200 lM1'AC. <br />,� /� n <br />�1��,�G' ��- f �� __ �-(�-D% <br />� <br />FEE <br />� c�0(o-� <br />Phone <br />Phonc <br />Phone <br />