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ELECTRICAL PERMIT APPLICATIORQ(C[RV (� <br /> CITY OF EVERETT PERMIT SERVICES i L MAY 3 0 200 ►� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vnvw.everettwa.Drg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM rj 31CITY OF EVER ices <br /> PROJECT ADDRESS <br /> Owner al Address <br /> City State/Zip Phone <br /> Stotalzip Phone <br /> Tenant Mail Address City / �y <br /> n hnsr,it� r 1/L11/ 1.1 I�ilart }1�//I!1 �O �/�ff �/)� °7� <br /> �9 iVi( Ul l urwrrYiey Ste, 1 Ph 2 <br /> Electrical Contractor Blau Address Ctty N,96.951 /Z <br /> �Y111K N% �� �,� ►-trig n`�_ . <br /> State License Number <br /> Contract Price of Work <br /> Contact Person (Plan Review) <br /> Proposed Use of Building <br /> IF— <br /> Description of Work to Be Done: <br /> NOTE: BEEN RACEWAYS. C OR AC CABLE. 3500 TO FEE <br /> 3500 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the some to be true and <br /> correct. All provisions of laws and ordinances goveming this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not ppresume to give aufhorilyto <br /> violate or cancel the pprevisions of any other state or local low reg l cling constructic or the <br /> performance of construction. That 1 am authorized by the owner of this property fo pl RC the <br /> work <br /> Zfor WAC application is made and I cot,,ply with the State Contractors Law 18.27 RCW end <br /> d <br /> Ignalere Dete <br /> Fps a13 <br />