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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 - �ww everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�3// .Sj ��� Si <br />PROJECT ADDRESS <br />C r, <br />Owner <br />Mail Address <br />�I <br />Ci�y <br />���p —o� <br />Cp�o7_13� <br />yJ- 5 <br />�S � <br />�"�Jc�i `l.� � �- <br />Slate2ip Phone <br />Tenan� A7ail Address Ci1y StatelZip � �� Phone <br />�� � <br />Z�'Cfrlili)�=71 �f S 3¢ <l �(/ ��9U FI/ `�f>o/ ��% �/ �v / <br />Eleclrical Con�raClor htail Address City Slate2ip Phone <br />ll��/i�_�S �y� ��� <br />Stale License Numbcr ' <br />�/-/I <br />Proposed Usc o( �uildinc� <br />Conlract Price of Work <br />Conlacl Person (Plan Review) <br />U�. /I S ���lil�l �lrEfi C_ /r(` � � i <br />Description of Work lo �e Done: i <br />NOTE: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily Ihat 1 have read and crarnined Ihis applicalien and kno�v fhr ;�mie to br• true and <br />conocl. 411 provisions ol laws and o�dinances e�oveining Ihis type ol �rorl, �rill be wmpleted <br />tvhefher specilied he�ein or noL Thc granting o! a pennif Aoes not nesdne fo [�ive aufhority to <br />�-iolafc or cancel the provisions ol any othr.r sfafe or local la�v •eguGtfing conSVucfion or the <br />peAonnance olconshuction. Thaf I am aidhonzeC by fhe owner ol this property fo peAorrn fhe <br />work for �vhich a. plication is rnaAe and I comP�)' wiih Ihe Slate Cnnlraclors Ln�v 7&27 RCW and <br />29G.200 VVAC. <br />FEE <br />c: �— <br />5 �' <br />� 7 <br />�� ... .� -�/ , ,i:rjr�;' :� V� tSfJ � —� J� <br />� <br />