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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 />'/_�S Z � l..�L't'V�n C��-� <br />PROJECT ADDRESS <br />Owner <br />a• <br />Tenant <br />Mail Address <br />Mail Address <br />Elecirical Conlractor Mall Address <br />p,���z t ltir, Dt <br />State License Number <br />i�IC/1�C �> .: t \ }�^:,_ �/W�n �i /Li'�'1\ <br />Proposed Use of Buildin �—�— <br />Description o( Work to 6e Done: <br />�J e,u � a La � ��, <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 />City <br />Cily <br />City <br />,,J cl `^/25 3U3 03� <br />State/Zip Phone <br />State/Zip Phone <br />Slate2ip <br />as �, <br />Contract Prico of Work <br />GI �� <br />Phone <br />Contact Person (Plan Review) <br />1 hereby certily }hat I have read and examined fBis appficafion and know fhe same fo be frue and <br />correcL All provisions ol laws and ordinances goveming fhis lype o� work will 6e completed <br />whefher speci6ed herein or noL The granling ol a permd does nof presume lo give aufhonty fo <br />��iol:�fe or cancel fhe provisions olany othar sfale or loca/law regu/afing construchon or the <br />pe�ferrnance o! constnicfion. That I am aufhonzed by fhe avner oI this property fo perform the <br />work lor �rhich application is made and I cornply �vi(h fhe Sfa. Contractors La�v 1827 RCW and <br />29G.200 WAC. <br />C <br />FEE <br />c <br />� <br />�67�/ -/z/ <br />