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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERM17 SERVICES <br />3200 CEDAR STREET, EVERETT, WA 95201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CRE�IT CARDS ARE NOT ACCEPTED <br />�ti�"�� 71`1 ��,� a,aaJ.. �Fv e v li � vJ �'1 `l n�Zo I <br />PROJECT ADDRE9 <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />Cily <br />City <br />Slate/Zip <br />State2ip <br />Phane <br />Phone <br />�n��i-r1��4���'�c, 'L22.1 L`�tV��rc�rv�icw. �iF Fvv✓otf W� �1bZc�1 �(�7_q�Z5���31�,`�� <br />Electrical Contractor Mail Address Cily State/Zip Phone <br />Shl�rri�,��t_�� r�lW <br />Stale License Number <br />�,11��� e b�rLi�r <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />� <br />��DO <br />Contract Price of Work <br />�JCL� ' � <br />Contac Person (Plan Review) <br />FEE <br />SS� <br />1 hereby certi(y fhat I have read and examined fhis application and kno�v the same to be true and �� �%`'�\ V-\�i i <br />correct. All provisions ol laws and ordinanc es ooveming this type o/ work �vill be completed <br />�vhether speulied herein or noG The grantrr.q o( a permd does not resume to give authority to <br />violate or cancel the pror�sions ol any other state or local law reguPting construc�ion or the <br />periormance oI construction. That I am aufhonzed by the o�vner o( this propeiry (o perlorm fhe <br />werk lor �vhich application is made an.i 1 comply with the Sfate Contractors Law 18.27 RCW and <br />296.200 Ih�AC. <br />