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ELECTRICAL PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />37_00 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPI !CiafIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ���� I �-1.�� ���Y w,ti. � <br />����- � �(Zo i�✓� _ �; <br />PROJECT ADDRESS <br />Owner <br />��� � � <br />Tenanl <br />Mail Atldress <br />ilJ (�vac�(�/��t �c <br />Mail Address � <br />Eleclrical Conlractor <br />� L� <br />Maii Address <br />Vd�L� ��iC a.��� <br />Stale License Number <br />�.����� <br />Praposed Use of uilding <br />L V�,/V�..-r <br />Cil <br />7 ' <br />� �s��.�� <br />City <br />State/Zip <br />Phone <br />State/Zip Ph ne <br />��-5�����- <br />11nLi.�LS.� 1,v1/ �Cf'-��'� <br />Ciry SlatelZip hone <br />,� -a"� k� ozl�' <br />CoNracl Price of Work <br />C�6) `�y � -`��,8 - <br />Contacl Person (Plan Review) <br />�l� <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 />I hereby certily fhat I frave read and exannned (Iris applicalion and l�now Ihe same to be truc and <br />correcL A!I provisions o//aws and ordinances goveming this type o/ a�ork will be completed <br />whefher spea6ed herein or not The granting ol a permit does not resume to give authority to <br />violate or cancel fhe provisions o(any other state orlocal law reguPaling construcfion or the <br />performance o/ consfruction. That 1 am aufhonzed by fhe owner o/ Ihis property to pedorm fhe <br />�vork Ior which apNlication is made and 1 compty with fhe Stafe Cuntractors Law 18.27 RCW and <br />29G.200 WAC. <br />! � � / <br />,�/ � <br />i% cii- %--��— �i ��–, �' � <br />`EE II <br />� <br />j—��I�_���;c� <br />