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ELEVTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SER`�ICES <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />_' �. �} 5—� s i <br />PROJECT ADDRESS <br />��� <br />Ow�ner <br />S� <br />z z � Sls�s.,� <br />M1tail Address <br />Tenant hlail Address <br />;rEGs E"��cM1.�c�,( �� v✓r�r} /�VL l��Sj <br />Electrical Contraclor Mail Address <br />6 r<�G es �G7 b5 <br />Slale License Number <br />�',� s �c��ti;,,41 <br />Proposed Use of Building <br />Description of Work lo Be Done: � 1�� �l �j �' �'c <br />L ��✓t I� <br />Cily <br />City <br />YG � ,_._« <br />City / <br />[I <br />;�-.-�- <br />Slate2ip <br />Slate/Zip <br />Phone <br />Phone <br />Z'� 5<� c� ..., v� ! fr�� 7 <br />State/Zip Y j� 7G GP Y� �`7 3 <br />i ovo "" <br />Contracl Price of Work <br />Conlact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE77 LOCAL SALES TAX CODE IS 3105 <br />I here,by ce�fi(y that I have iead and examined this applicafion and know fhe same to be true and <br />correct All provisions o� laws and ordinances goveming this type ol work �vifl be completed <br />whelher specdied herein or not The grantin9 of a pennd does not resurne to give aulhordy fo <br />vinlate or cancel the provisions o( any other stafe or local law reguPting cor,strur.tion or the <br />F dormance ol consVuchon. That 1 am authorized 6y fhe owner of this property to peAorm the <br />� urk Ior which application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br /><io.20G I�S�C. _ <br />� i ,�, � i-�, �-�- <br />�/�11 /0 7 <br />