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ELECTRICAL PEF�MIT APPLI�ATION <br />f:l'fY OF EVERETT PERMIT SER�OICES <br />320.0 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 CARC� ARE NOT ACCFPTED <br />� z, s- — s` c� <br />PROJECT ADDRESS <br />{�Lbt��'.lii��= <br />Owner <br />Tenant <br />jNl'- LiNI <br />Electrical Contractor <br />Mail Address <br />Mail Atldress <br />1=l.L=Li !Lf l.. <br />Ma�l Addresa <br />�� L. L� ��i �= �. �M1 C� S�% T <br />Stale License Number <br />Proposed Use of Building <br />Description o( Work to Be Done: �— ti V �' �` <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWaYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />Ciry <br />City <br />� � }�.'� f''I <br />State/Zip <br />Stale/Zip <br />State/Zip <br />Contrect Price of �Vark <br />Conlact Person (Plan Review) <br />1 hereby certily that I have read and examined (his applicafion and know the same to be truE and <br />correct. AI! provisions o/laws and ordinances governing this type o( woik will 6e completed <br />whether specihed herein or noL The c�ranting ol a pernut does not presume to give authority to <br />violate or cancel the provisions o/ any other state or local law regulating construction or the <br />performance ol construction. That 1 am authorized by the owner o! th�s property fo perlorm the <br />work for which app/ication is made ard I comply with the Stafe Contractors Law 18.27 RC W and <br />ZyU.2�� w.Q�. <br />FEE <br />%�- r�a � <br />� <br />Phone <br />Phone <br />Phone <br />