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ELECTRICAL PERMIT APPLICATI�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 />� � 7 ., .�'(� )�(_ ,$ UJ % <br />u_-� t7�7�R� � J I � Z �� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />�%��� ��d16/� S <br />Mail Address <br />Mail Address <br />��-L����/1 �/ /—�L_�J�\�L <br />Electrical Contrector � Mail Address <br />�L(�v��l�=c.00 -�N� <br />Stale License Number <br />�.1 1^f=� <br />Proposed Use of Building <br />Description of Work to Be Done: /�-'L �1 '' �^� <br />NOTE: WIRIIJG IN NON-DWEI.LINGS IS REQUIRED TO <br />BE IN RACEWA'!S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />Stale/Zip <br />State/Zip <br />Slate/Zin <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />I hareby certi(y that 1 have read and examined this application a��d know fhe srme to be true and <br />conecL All provisions o/laws and oidinances governing this type oI work will be completed <br />�vhether speci6ed herein or not The granting oI a permd does not resume to give aufhonty lo <br />violale or c�ncel Ihe provisions o/any other state orlocallaw reguPting censtruction n� the <br />pe�lonnance of consVuc(ion. That 1 am authorized by the owner o( fhis preperty to pe, form the <br />work (or which application is rnade and I cernp/y wilh the Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />S 5^ `��' <br />�/, <br />�/`(_�.,, ; `�l y�/4 ,�� <br />� Si naWre _ _ ' Date <br />, �;� � � <br />c� ��� <br />Phone <br />Phone <br />Phone <br />