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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_�,_05 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8910 - FAX425-257-8857—www.everetlwa.org �� 54�'/�/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />;� il l, �,�tivtiL, i /��z�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />(�7aail�zN � Ill� Stinrr� � <br />Mail Address City <br />Mail Aadress City <br />PU �r,�, � S' � !�L �v , <br />Conlraclor Mail Address <br />L-1,.�;%_�L �' �'Jl� � <br />Slate License Number <br />� � .t- <br />Proposed Use ot Building <br />Description o( Work to Be Done: <br />L ��I <br />NOTE: �NIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />.� c Ueu� l/ Q���o I �s�i <br />State/Zip <br />State/Zip <br />{r qk II$ ���71 z•�s-y <br />State/Zip <br />,J S�� �-' <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />11��: L� <br />1 hereby certd}� fhat I have read and exammed this applicaticn and know fhe same to be frue and <br />conect All p�ovisions oflaws and ordinances goveming fhis rype o/ work �vill be completed <br />whether specdied herein or not. ihe granting o/a permd does not presume fo give authonty to <br />vielate or cancel the provisions �lany olher state er local law regulating construction or the <br />peAcrmance e/ construction. Thaf I am authenzed by the owner a(lhis property to peAorm the <br />we�k lor �vhich app6cafion is made and I complv u-dh the State Contractors Law 78.27 RCW and <br />?96.200 WAC. � <br />� <br />.�_ .�'_� - -% � �/1-r%��- <br />FEE <br />- /ofi Z <br />Phonc <br />Phone <br />Phone <br />