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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 />t�?PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />j U�-i l(a ( c'l N� T L• l.i) <br />PROJECT ADDRESS <br />)�c�.4.l�e 1=�r��5.ilc.���� lc� �-{ �L� irti�� y��.`-� �.r�-tri�l l,�sc� �-(?S. �� -74ti <br />Owner Mail Address Ciry StatefZip Phone <br />Tenanl <br />Mail Address <br />Cily <br />State/Zip <br />Phone <br />�r,, ^ �tccru���l-.�.c. �c..?:c A���:.....C�}vr� iJ�,�a-<.'i-t� �.�r `ib_>-C3 425�7�To��1�� <br />'1�� .l r_ v. <br />EleGrical Conlraclor Mail Address Cily State2ip Phone <br />i( l:SCC'{ 7S 3 Cl-) <br />Stale License Nwnber <br />S r t� <br />Proposed Use of Buildinc� <br />Descriplion o( Work to �e Done: z.C'�'�..'1 �>>_ ��.�_� C�nc. ��y.9� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWNYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby certily that 1 have reao and examined this applicafion and know fhe same to be frue and <br />conecL All provisiau o/laws and ordinances governiny fhis type oI �vork will6e cornpleted <br />evhelher specilred herein or not The granting o/ a Aernxt dor_• not�resume to give authonty lo <br />violale or cancel Ihe provisions o( any other s(ate or loc;3llaw re�u�aiLog consfruc6on or the <br />per/onnance oI construclron. That 1 am authori<•ed by fhe owner of this property to peAonn fhe <br />work /or �vhich application is made and 1 comply with the Stale Contracfors La�v ;8.27 RCW and <br />296.200 WAC. <br />i � <br />� ,.. �_, '?-': :-Z./J:-- <br />- � '�-1 - G � <br />FEE <br />