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�LECTRI�AL PERiViIT AP�LICAI'ION <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 />i / l - �� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />c<_ , <br />ElecUical Contrxlor <br />Slate License Number <br />L,��c� i <br />h1ail Address <br />Mail Address <br />A1. il ACdrC;s <br />Proposed Use of 8uilding <br />Descriptian of Work to Be Done: � C �- � <br />NOTC: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />s=��5" <br />Gty <br />Cily <br />�/ ;,� <br />StatelZip <br />Slale/Zip <br />�� � � �� 5 �(� :3- <br />�� � i <br />Cily Stale/Zip <br />Conlract Price of Work <br />Phonc <br />71.�% <br />Phone <br />� �� �; <br />Phone <br />Conlacl Person (Plan Review) <br />1 hereby certify th?t I have read and examined this application and know the same to be true and <br />correcL All provisions of laws and ordinances �ovenung Ihis lype o( work will be completed <br />uhether speci6ed herein ornoL Tha granting o/ a permif does not resume to give aufhonty to <br />violate or cancel the provisions o/any other stale or �ecal la�v reguPting construction or fho <br />performance o( consVuc6on. That 1 arn authorized by fhe owner of this property to perlomi the <br />�vork lor �vhich applicafion is made and I compiy with the State Contractors Law 18.27 RCW and <br />296.200 lNA C. I <br />! Ili . r %,.� � .�..y <br />FEE <br />�� <br />