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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 a—/ S�—� � <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � D 70"3-� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />' I ��l_,'.� ���1�.K�' �i <br />PROJECT ADDRESS <br />/ <br />l���I��LC <br />Owncr <br />l/6�� ' ;� � <br />Tenant � <br />� ��L � _ ( <br />[Icc�rical Conlractor <br />Afail Address <br />Mail Addrass <br />�C ,�•x.�(l f <br />Mail Address <br />Cily <br />�=. �e <br />���Y <br />Ciry <br />i_'1 i�=�� L- `�� C�� i\ <br />Slale License Number <br />� <br />—]SI"1�� l '�C A1.�� � <br />Propased Use of Buildin� <br />�' � <br />Description o( Work to �o Done: ���_ ��"' ��- �} i�( � �''�(L� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />E3E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stdte/Zip <br />Slale/Zip <br />Phone <br />Phone <br />�z . ��-�i 7a�-- ; ��-� fi <br />State/Zip Phone <br />7I� LL `� <br />�k"%0. . <br />ConUacl Pr'ce o( Work <br />Contacl Person (Plan Review) <br />���4� �-,���r ��,`�� � <br />1 hereby ccrti�}� Ihaf 1 hove reaA and examined (his appli:ation and kno�r fhe sarne fo be true and <br />correcL All provisions olla�vs and orAinances c�o�rerrnc3 fh�s type o( irork �rill be comp/eted <br />�rhether specilied herein or noL The r�ranfin� o! a perndf does nof presume fo give aulhonty fo <br />eiolafe or cancel tl�e provisions olan}� othe� sfate or local la�v rec�ulating consVucfion or the <br />perlonnance oI conslruction. That 1 arn aufho�:zed by fhe o�vner o/ Ihis propert}� to perfonn the <br />�vak lor �i�hicR applicalion is nrade and 1 comp;y �vifh (he State Contractors Laiv 1827 RCW and <br />29G.�00 6YAC. <br />i ; , <br />, .. — � / <br />���' ��� �-!�x-�v �-- - . ,�i/�/`���,� - <br />FEE <br />J� / 7� ! <br />'� (/c� �� / <br />