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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR 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 />-�—�i 3 r (.L7 C' .c�� ���c: f � �'"1 E' �� i ei.C� `IJ i� l J L <br />PROJECT ADDRESS <br />�� � <br />Owner <br />i <br />Tenanl <br />� <br />� �t 5 �i i 1"��% <br />Mail Address <br />Mail Address <br />:�, � �Y, ��x«,�i.�r.. rr � ra. <br />Electrical Conlraclor Atail Address <br />�,15 �t �o � y��vv <br />late License Number <br />Propased Use of Buildinc� <br />Descriplion of Work lo �e Done: <br />NOTE: WIRiNG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR P.0 C.4BLE. <br />3 <br />Clty <br />Cily <br />City <br />Stale2ip <br />Slate/Zip <br />,D(- <br />StalelZip <br />����ciG <br />Contract Price of Work <br />�i�s -»o ��J3 <br />°��C <br />Plione <br />Phonc <br />Canlact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 3105 <br />I hereby ce�tily fha(1 hn��e read and exarnined fhis application and kno�v Ihe �ame to be true and <br />conecL All provisiau ollaws anc! ordinances govemmg ffus Q�pe ol �vork �rill be comploted <br />�+�hefher speci�ed herein or noL The gr��nting ol a pernut does nof �resume to give aufhontp to <br />violafe oi cance/!he provisions oI any other sfate or local luw regulating construction or fhe <br />iv�k (or��vh ch �cor� ctat or ls n a�de anc% 1 cono �ied b fhe Sfafe Cor h�acfors�La v 18.27 RCW �and <br />296.200�Y�C. �� � 1 <br />�i� _/ ,�../ —� <br />FEE <br />`'.1 ���c 3 <br />Plione <br />�'ynature ad _�I�/ �� <br />i� <br />