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r <br />ELECTRICAL PERI►�lIT 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 <br />j�_�:�i��� �'.�;-�- /"�.r� <br />PROJECT ADDRESS <br />: '�,,.; � L�.,�_� � �'�:���. . i <br />Owner Mail Address <br />Tenanl <br />`� ,'�.=-F',I�,_ �L <br />[lectrical Conlraclor <br />�\i��..,�'� _��i e_ � <br />Stale License Number <br />Proposed Usc ol Ouilding <br />Mail Address <br />Mail Address <br />Cily <br />Cily <br />> �.lv"'�C . <br />City <br />�� i ' -i �\,_i--V. <br />� <br />�.;� 1 �._ " �'�il�� <br />Stale/Zip <br />Slate/Zip <br />Phone <br />Phonc <br />�1 ��.� � �_ ��� . ' ��`I �I <br />Slate/Zip Phone <br />Contracl Price of Work <br />Conlad Person (Plan Review) <br />�, <br />Description of Work to De Don�: ', > �' � �i -i'' ��'�.V�—� ��'� � � � ��V � �. � � ti V� ��� � � --ti <br />. � � ,� � . <br />�r� i '1� � r. � \ i�'-� �7 <br />, ..... . ...\ �.�. �-. . .. <br />NOTE: WIRING IN �+ON-DWELLINGS IS RE�UIR[D TO <br />BE IN RP,�6WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 f�eieby ce�tily fhaf 1 ltave rer�d and exantined Utis applrcafion and kno�v fhe sante to be fn�c and <br />correcL All provisions olla�rs and ordinances governmg Ihis type o( n�ork �vill be complefed <br />�vhefher specdied herein or not. The ��anfinc� o( a perrtuf does no( presurne ro give authority ro <br />violafe or cancel the ��rovisions o/ any other state or local lau� re�ult�ting construction or Ihe <br />pedo�mance oI cons ruction. That I am authorized b}� fhe o�vner ol U�is propn�ty fo peAomi fhe <br />urork lor �rhich application is rnade and 1 comply �vith the State Contractors Law 18.27 RCW and <br />29G.200 WAC. <br />�'i <br />�� <br />� � -�- -_ __ � � I � ; .� <br />FEE <br />_\ <br />Eiu:>�1-��t-i <br />