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ELECTRICAL PERMIT APPLICAT��N <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 />o � 1 �� �-� � � <br />PROJECT ADDRESS <br />� �.� <br />Owner <br />Tenant <br />i / .,1 <br />� <br />Mail Address City <br />Mail Address Ciry <br />���o�i ��e i}l �iJ� � ��y <br />Elechical Contractor Mail Address City <br />�l�i�twZE�.���a3 c��, <br />State License Number <br />Proposed Use of Buildinc� <br />Description ol Work lo �e Done: <br />� �OL �_ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3705 <br />�u s ZJ�w GI �' �� �y �5J33�J-G <br />State/Zip Phone <br />State/Zip Phone <br />!� �_ S n 9$d `i0 ��1�'"i�3�o- 9a <br />State/Zip <br />Contract price o( Work <br />Contact Person (Plan Review) <br />/ hereby certily fha(1 have read and en•arnined fhis application and know fhe same to be true and <br />correct. All provisions ollaws and ordinances goveming this type ol work will bct completed <br />whefher specilied herein or noL The granting ol a pornut does nof presume to give authonty to <br />violate or cancel the provisions ol any ofher sfafe orlocallaw regulafing construction or fhe <br />perfomiance o/ constnrcfron. That ! am authonzed by fhe owner o� this property to pedorm fhe <br />work Ior which application is made and 1 comply with the State Confiactors Law 18.27 RCW and <br />296.200 WAC. <br />/ � � <br />� _ ."i.i y / lI /%�l/I <br />,,9 gnat� Date <br />l ` C <br />FEE <br />Phone <br />