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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 A,�9_/b <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � <br />�/ov9.-��13 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l��31� �-a h-� <br />PROJECT ADDRESS <br />Tenan: <br />�����' ( �l� S o1���� �C;%��.. <br />Mail Address ���Y <br />--�� �J�'l-P — <br />� <br />Mail Address ���Y <br />� r /' d <br />::P.����v� <<�.30<� 5� �3c;�c�i�� <br />Electrical Conlractor Mail Address <br />I����..��5 ��/�I _ <br />S��ate License Number <br />Praposed se of uilding <br />�. <br />Description of Work to Be Dono: �c "`c/ (� <br />Z <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />City <br />Cy�s-� <br />�/,� � 3l -y�� <br />Stale/Zip Phone <br />Sfale2ip Phone <br />� <br />/d� , � . � ��`�' <br />Slate/Zip � Phone <br />r/�Do �— <br />ConVaC�Price of WorSc <br />Contact Person (Plan Review) <br />�S <br />1 hereby certily that I have read and exarnined this application and know the same to be true and <br />correcL All provisions ollaws and ordinances goveming this type of work wi/l be completed <br />whe(her specilied herein or noL The yranting of a penmt does not presume to give aufhonty to <br />violale or cancel the provisiais of any ofher state or local law regulating construction or the <br />pe�fonnance ol consfrucfion. Thaf I am autho�ized by fhe owner of this property to perfomt the <br />work lor' which applicafion is made and 1 cornpty u�ifh fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />�1��'`I- L�t� <br />