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ELECTRICAL PEFcMIT 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 />>Z/. / ,� 7`������� lJ2, <br />PROJECT ADDRESS <br />y�S <br />7Z-.%% <br />SvM�fin�) c,� n i� iiT D'/:z 3s ��" SI' �r� y�.�oi Y�/,� <br />Owner ^ Mail Address City Stale2ip Phone <br />Tenanl MailAddress City SlatelZip �1 phone <br />S <br />t��'i-�/�r�h'ft f�i � ��o� (�tl� ��/ �i% 7��•t�l �s��/4/ <br />Eleclrical Conlractor hlail Address Cily State2ip Phone <br />��'�-�4 �t�-�'J� iY.� � �' <br />Slate License IJumber <br />���l2- <br />Proposed Use of Duilding <br />Descrip�ion ol Work lo Be Done: ���L�l� / I� C/2G u/ j�(S ,� <br />NOT[: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />BE W RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Conlracl Price of Work <br />CoMacl Person (Plan Rc vicw) <br />1 hereby ce,lily fhat 1 have read nnAexnrttined this application and know Ihe same fo be tnre and <br />correc(. All provisions olla�vs anA oidinmices govemui� this lype of worA will Ge complefed <br />�vhelher specilied herein or noc The granfin� o! a pernut does nof resurne to give authority to <br />violafe or cancel the !�rovisions o/ an}� other sfafe or local law �eguPting consiruction or (he <br />perlormm�ce o/construcfion. That 1 arn authorized b}� the o�vner o�fhis property to pedonn the <br />�vork /or which a��ulication is made and I contpty wifh fhe SWte Contractors Law 18.27 RCW and <br />296.200 WAC. , <br />G <br />FEE <br />3S� �' <br />�o�o�o� 1�3 <br />