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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9A201 <br />425-257-8810 - FAX 425-257-8857 — www.e,ierettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />pp <br />C V--"f T � �h �FJ7� (J� 9g�}4d 3FJ`1't6tJD <br />Owner Mail Address City State/Zip Phone <br />Tenant Mall Address City Stale/Zip Phone <br />LCC- P_e 0ejuo- ty)U 17- (%,`1 7o `107( <br />Electrical Contractor Mail Address City Stele/Zip Phone <br />I -tr('` VA _ <br />State License Number Contract Price of Work <br />Contact Person (Plan Review) <br />Proposed Use of Buildingp�/] <br />_ <br />Description of Work to Be Done: c c J er;5 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />1^J <br />CITY OF EVERETT LOCAL. SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give auB.ority, to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />That <br />e of construction. m authorized by the owner of this property to perform the <br />ich application is m d I comply with the State Contractors Law 18.27 RCW and <br />C. <br />2-natuFe <br />Date <br />