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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 P.RE ACCEPTED FROM 8 AM TO 4 PM <br />`r � �� Z(� ( <br />Z. 1 I�j � i�� �= u c r�c i/ ; ��J/l <br />PRflJECT ADDRESS <br />Owner <br />Tenant <br />1�"1 C�_i�� �jf�rr`L= : <br />M11ail Address <br />Mail AdAress <br />L i-L' F �L`�� : <br />Electrical Contraclor Mail Address <br />r2 <br />Cily <br />City <br />�;_ � � <br />CLE�i_C� �j�3�7�. �- :�� � ''� �1 <br />State License Number <br />��h <br />Propo ed Use oi Building <br />Description of Work ta Be Done: <br />�� c2� �cc <br />,�, <br />�,�c�/ l���v� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRFD TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />�] <br />StalP'Zip <br />State2ip <br />� l.C.� 11 i l �l� <br />State/Zip <br />Phone <br />Pnone <br />Phone <br />ISoc� `� <br />Contract Price of Wo:k <br />rJoc—� C'���„r��!5 �.�; �r7�� <br />Contact Person (Plan Review) <br />c�� �Xih � �rt�CT <br />L�� �,Qli�c <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereUy certil}� that I have read and examine ��� application and know fhe same to be Vue and <br />conecL All provisions o(laws and ordinances govemmg fhis type o( work will be completed <br />nd�ether sper.d�ed herein or noL The �ranfing o/ a perrnd dues not reswne fo give authority to <br />violate or cancel Ihe provisions o/ any nther sfate or local law �eguPting construc6on or the <br />performance o/ consVucfion. That 1 am aufhc�ized by the rn•mer of (his property to perform the <br />work lor which applicalion is made and 1 compty �vith Ihe State Conlracfors Law 1827 RCW ard <br />296200 WAC. <br />i <br />�,,� �� i; � ; , � . � ; � �-, � � � `� _ �, <br />FEE <br />� �� �� <br />7 i I I <br />I <br />