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� <br />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 ARE ACCEPTED FROM 8 AM TO h PM <br />� q <br />`%�%=� l /.i �� GCJ _7 <br />PROJECT ADDRESS <br />1 �-hC! /��'vl� <br />� ,1��._i . _ . _, <br />�wner <br />� <br />�-� <br />�. '"GJ ��. <br />°lectrical Contractor <br />itate License Number <br />Mail Address <br />Mail Adtlress <br />M11ail Atldress <br />'roposed Use of Buildiny <br />)escription of Work lo �e Done: ��(7�y+ J f � G��-�-% <br />lOTE� WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />r.l w,9 5'�� i�� <br />��N State2ip <br />��J � <br />City <br />City <br />;ITY OF EVEF2ETT LOCAL SALES TAX CODE IS 3105 <br />hereby certil}• that I liave read and examined this application and know the <br />onect. A/l piovisions o/laws and ordinances govermng this type of work w <br />�hether specified herein or noL The granfin� o( a permd does not presume <br />io/ate or cancel (he provisions o( any other state or /ocal lan� regu/ating con <br />eAormance of consfruct�on. That f am aufhonzed by the owner o( fhis prop <br />�ork7or which applic2lion is made and 1 comply with the State Contractors L <br />96.200 WAC. <br />�� 1r, �9/�J <br />SignaWre ' Da e <br />J <br />Sl3te2ip <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Revie�.v) <br />° fo be true and <br />completed <br />�e authont}� to <br />tion o� the <br />o perform Ihe <br />8.27 RCW and <br />FEE <br />Phone <br />� ��� � <br />Phone <br />Phone <br />