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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 />7�.� �3 '-�' s�_ S �„� , <br />PROJECT ADDRESS <br />L Frn/�S <br />ow�e� <br />Tenant <br />72-s S3 t—L S—r S� <br />Mail Address <br />Mail Address <br />�.li�'2wi�tK.�NSTR+rc-no>J bs.� <br />Electrical ConVactor Mail Address <br />C(-t�2w� � � � 30 ;Zy✓� <br />State License Number <br />i . �.� �� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />�!L <br />NOTE: WIRING IN NON-DWELI.!NGS IS REQUIRED TO <br />BE IN RACE\NAYS, A^:: OR ��C CABLE. <br />CITY OF EVERETT LOCAL SAI_ES TAX CODE IS 3105 <br />Clty <br />Gly <br />;_, h! <br />cuy <br />�,�E-n..c � �J/� <br />State/ZJp <br />Stata2lp <br />5fale2lp <br />-�� �.So. � <br />Contrect price of Work <br />Phone <br />Phone <br />Phone <br />✓�-��5,9.��02� 4'�'�e- <br />Contact Person (Plan Review) 8�U <br />1 hen�by certily that I have read and exe;n7ned this application and know fhe same to be true and <br />correct. A!1 provisions of laws and oruinances goveming this type ol work will be completed <br />whetFier specified herein or not. The granting of a permd does nof presume fo give authonty to <br />violate ar cancel the provlsions of any other state or local law reg�;ating construcUon or the <br />performance of constn:ctlon. That I am authorized by the owner of fhls property to pertorm the <br />work lor which application !s made and 1 comply wifh the Stafe Confractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />� lf i( - �(�S <br />