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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMI :' SF_RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �� _�0 -Q6 � <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �.06/� ��C� <br />APPUCATIONS ARE ACCI=PTED FROM 8 AM TO 4 PM <br />�� son ,��'�- � v�-Q,l'� <br />PROJECT ADDRESS <br />� cd/_x GI .� GG,� <br />)wne� lylail Address <br />� � <br />����/�/� �L1 � /.�.�'� <br />er!anl Mail Address <br />L _/� C�C �S [� %c�7-� c <br />E�ectrical Conlraclo� Mail Address <br />�{a✓,� ,�=�d39,�i� ����`I�� <br />Slale License Numbcr <br />--' 1 �I/�f''!� <br />Pro Use of Buildin� <br />Description of Work l0 8o Done: � ��� !"rQ' <br />NOTE: 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 />Cily <br />Stale/Zip <br />State/Zip <br />Phone <br />Phone <br />�, /i�G✓ S�J�i. wr•� �!� �f11 <br />Stale/Zip 3�� hone <br />�2 % <br />� 200, o d <br />Contracl Price of Work <br />Conlacl Person (Plan Review) <br />FEE <br />1 hereby certily fhaf 1 fiave read and exemined this app/ication and know fhe sarne (o be truo and � U lP l v' �' N�� <br />co�recL All provisions ollaws artd ordinances goveming this ly,oe ol work will be complefed <br />whether spec�(ed herein ur not. 7he �ranfing of a permd does nof prosume to give authonty fo <br />violate or cancel fhe provisions of any ofher state or /ocal law regulating conslruction or the <br />performance of conslruction. T; iat 1 arn aidhonzed by the owner of thrs property fo per(omi fhe <br />work for which applicafion is rnade and 1 conrply u�ith fhe State Contractors Law 18.27 RCW and <br />29G.200 WAC. <br />,i .�` /� ,.; <br />�, <br />�.- _/G - �I <' u <br />