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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 C� _/� _p� <br />G t'�C�—b.`.� <br />71 �l � 3 �-�� ��( � <br />PROJECT ADDRESS <br />���-(�-F G�rKsl,�r� %ly 33 � `-I F�.�-�� c�� ��� `�Zs:�r-�s <br />Owner Mail Address City Slale2ip Pho�e <br />Tenant <br />Mail Address <br />City <br />Stale/Zip <br />Phone <br />�out.c� FI F c.��i � l/// S 5: c�_ 5<- -- f?� (�: �- Sfe �rtis �✓�f- qkZsB� �!L 5-��5-`/o=L <br />Eleclrical Conlreclor Mail Address City Slale2ip Phone <br />SC`�Ct N�;� F � 9y51� (' <br />Slate License Nuinber <br />I�L� S I Cit-L''.� C� <br />Proposed Use o( Building <br />Descriplion of Work lo Be Done: <br />�K <br />NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO <br />BE IN R4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOC/�L SALES TAX GODE IS 3105 <br />��So��`- <br />Contract Price of Work <br />�� ti„ /l � � l�o w�--�.�� <br />Conlact Person (Plan Review) <br />1 here6y certily Ihat I have read and examined this applicafion and know lhe same to be true and <br />correct. All provisions olla�vs and ordinances c�overning fhis lype ol work rtill be completed <br />whefher specilied herein or noL The granfing e( a pernut does not presume io give uufhonty fo <br />violate or cancel Ihe pruvisions olany ofher state or localla�v regulating consfruchon or fhe <br />performance ol construc6on. That 1 arn authorized by the owner ol Ihis propetty to perform the <br />work /or which applicafion is made and I cornply �vith the Sfafe Contractors Law 1 A27 RCW and <br />296.'L00 lh'AC. <br />FEE <br />c�t�o5-c�S� <br />