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; <br />ELECTRICAL PERMIT APPLICA�iON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everethva.org <br />� _�/_p 5 <br />APPLICATIONS ARE /�CCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />i � ► � 3s .��, � �" <br />PROJECT ADDRESS <br />Owner <br />Ten�r! <br />Mail Address <br />Mail Address <br />Gry <br />Ci�y <br />State/Zip <br />blale/Zip <br />Co564 -�3r <br />Phone <br />Phone <br />SC,UIJC� � f{cx�C. !l'!L) ��/14G-uEr—P", �J-%G'iU��'t w/t- `fV�ZIZ �%f,��Z7t €'� <br />Electrica� Conlractor Maii Address City Stale/Zip Phone <br />S�uNct�/�3��T�1 <br />Stale License Number <br />Proposed Use o( Building <br />Descriplion o( Wark lo Be Done: i���� /9�t+P �'����t'!�� Jl �"ti�`�-G. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />��/SOc�". <br />Contracl Price of Work <br />Conlacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy certily that 1 have read and exami,ied this application and know the same fo be true and <br />coirect. All provisions o/laws and ordinances goveming tBis type ot work �vill be.completed <br />whether spec�fied herein or noL The grontin� o/ a pernut does not resume to g��e auttiority to <br />violate or cancel the provisions olany other state orlecal law reguPting construction or the <br />peAormance o( consfruc(ion. Thaf I am autho� ed by the o�vner oI this property to perform fhe <br />work /or which applic t�on is made and I compy with fhe Sfafe Contractors Law 18.27 RCW and <br />296�10�t�VAC. � <br />�� <br />N/�� /. s_ <br />FEE <br />;-�� <br />��,; <br />