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ELECTRICAL PERMIT APPLICATION <br />GI'�Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - F,4� 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��_�'� �� <br />�r�i 33,....� S-� <br />PROJECT ADDRESS <br />oW��� <br />.�-- <br />Tenant <br />� �RN <br />Eleclrical Conlraclor <br />Mail <br />Mail Address <br />Mail Address <br />�E� D,s�O� g�rc 3 <br />Slale License Number <br />fZES i DG�N � I� L <br />Proposed Use o( Building <br />Description o( Work to 13e Done: <br />c�ry <br />City <br />Ci�y <br />C-'��Go�'-i'`�3 <br />Slale/Zip <br />Slafe/Zip <br />Stale/Zip <br />��/S�d <br />Contract Price o(1^�ork <br />Conlact Person (Plan Review) <br />��i TcN�_4 rl�u�o2� Sa�ff .rni�/�¢�-r�E <br />NOTE: WIRING IN NO�-DWELLINGS IS RECIUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ccrti(y thaf 1 l�ave read and exarnined tl�is applicafion snd know fhe sarne to be true and <br />comect. All provisions ollaws and ordinances govenun� this fype o( �rork will be completed <br />whefher speci6ed herein or noL The granfing o( a pernut does no( resume fo give aufhonty to <br />violate or cancel the provisions e�any other s(ate orlocal law reguPting construcGon or the <br />peiformance o( construction. 7hat 1 arn authonzed by f0e owner o! fhis prope�iy to per(orm fhe <br />�vork lor which anplication is made and 1 comply wi�h the Stafe ConVactors La�v 18.27 RCW and <br />296.200 WAC. <br />FEE <br />/� �J� 'C��� <br />l' <br />4zS <br />Phone <br />Phone <br />Phone <br />