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r <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CCpAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />;) �jcJ j(� ��✓ /!7 �/ C.�%i� <br />PROJECT ADDRESS <br />�7t�! U.-� S C ��iJu j�-�.c' ti�� ��.t C� <br />Owner Mail Address Ciry <br />Ten�nt Mail Address Cily <br />Stat�/Zip <br />Stale/Zip <br />(,': C� <br />,� <br />Phone <br />Phone <br />��� L ��L, <br />Eleclrical Conlractor Mail Address Cily Stale/Zip Phone <br />Slate Licenso Number <br />Proposed Use of Buildinc� <br />Descriplion of Work lo �o Dono: <br />� ! t�, I CL['Yt <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 />� Di�Li <br />Contracl Pfice of Work <br />Contacl Person (Plan Review) <br />—_.G���%� . <br />I hereby certily that I have read and examined this appfication and know fhe same fo be (rue and <br />correct. All provisions o(/aws and ordinances goveming fhis type ol work will be cornpleted <br />whefher specified herein or noL The granting of a permd does nof prosume fo give authonty to <br />violafe or cancel the provisions ol any other stafe or local law re5ulefing constnicfion or fhe <br />perlormanco o( construction. That 1 am authonzed by fhe o�vner ol fhis property to perfonn the <br />�vock for which application is m�de and 1 compty �vith the State Contractors La�v 1 B.27 RC W and <br />296.200 WAC. <br />G <br />FEE <br />