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ELECTi�IC�►L P�RMIT A�P�ICA�'�ON <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 At2E ACCEPTED F;20M 8 AM TO 4 PM <br />�1V�L.� � ��'" k��C` \� <br />PROJECT ADDRESS <br />���\1'���s.1�:�, `�1Or�3`�+t��?�Q�'1,� \��:�'�! ��<�.�''1`�3:`� `�7.S�3r-��i�c1�1� <br />OHmer Mail Address City Slale/Zip �none <br />Tenant <br />Electrical Coniractor <br />Mail Address <br />Mail Address <br />A�Cc �C �`:'�,���, <br />State License Number <br />Use of Buildinq <br />Description o( Work to k3e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, M� OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />State2ip <br />Slale2ip <br />`�''1��, - <br />Contract Price of Work <br />Contact Person (Plan Review) <br />� <br />I heieby certily fhaf I hnve iead and examined (his applicalion and know the same to be true and <br />correcL All provisions o/ laws and ordinance s govemmg this type ol wo�k �vill be :ompleted <br />whelher specified herein or noL The grar�ting oI a pemur does not resume to give authonty fo <br />violate or cancel the prnvisions o/any o(her stale or local la�v reguPfing conShuCliOn nr (he <br />performance. o( constn�ction. That I am authonzed by Ure owner ol this property to perlonn the <br />work Ior �vhich app/icafion is rnade and 1 cornpty wilh fhe State Contractors Law 18.2? RCW and <br />296.200 V �� a C. <br />FEE <br />Phone <br />-cx <br />Phone <br />� � �� �(1�u9-�7��� <br />_�� ����c�s� L, ��\��C,1 <br />