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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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 14� ��.e�,�n; � A-�*c �vt.� c�', W A. <br />PROJECT ADDRESS <br />c� _ -�� -o� <br />C- o6dy�� 87 <br />� 3�0 �y3S Gs9a <br />?.-�_`_y L�ta.-zJ '3`�32 �23� S�I�Jt ��:v� �IJ�aSF�.9o223 <br />OWner MailAddres; Cily Slate/Zip Phone <br />Tenanl <br />A1ail Address <br />Cily <br />Stale2ip <br />� <br />Phane <br />� �I Cl l. )1 � � C� `— — --^ <br />Eleclrical CoMraclor Mail Address City Stale/Zip Phone <br />:�.. �{ hl � 1 Iv�Zn <br />Stale License Nwnbe� <br />�C � � C� !�r v�P f . <br />Proposed Use of Ouilding <br />Description of Work to Be Done: �� t ti\ �,v e �\) ]{�y�� <br />NOTE: W IRING IN NON-DW [LLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�,� (il�il\Ptti <br />Conlract Price of Work <br />Conlacl Person (P�an Revicw) <br />1 hereby cr,rti/}� �hat 1 have reaA anA exarnined lhis applicafion and know fhe same fo Ge true and <br />cortecL All proeisions o/ latvs and nrdinances got�enung tbis f}�pe oI work �vill be complefed <br />�vhefher spea/ied hciein or not The granfing o/ a perrnrt does not uesume lo y�:e aufhonry lo <br />vio/afe or cancel the provisions o/ any oUier state or local law regul,�fin� consfn��fion or the <br />pedonnance o/ construcfion. Thal I am authonzed by fhe owner o/ fhis property lo peAomi fhe <br />�rork Ior which application is made and 1 comply wifh the Slafe Contracfors Law 18.27 RCW .vnd <br />29G.200 WAC. <br />/� <br />� <br />FEE <br />