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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 />_;�3iy �<3��,�1 /y L-�,-,,� <br />PROJECT ADDRESS <br />Y�- _;- <br />��7-�/ 7 <br />�/���;-/�.�� �%�����f��•�, S.3iy i�����✓�7��r�� ��.-��� ��'� �y��3 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />/r'�`�_s=s ��:... / V=%�C��,-�, � L'v,� �vi� 01 y `i %�r /, .�rl��-, (�/� ���.13 <br />Electrical Contractor Mail Address City � State/Zip Phone <br />� ��L �' � G��' �v 7 7�-/� <br />State License Number <br />fI �J� ��C�� � <br />Proposed Use of Building <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �c�f'`� c � w�%�`�� �-� �S � �, �,,jc, /r � /,�:,, � ,— �-�;;s.--, <br />��,1f � � �r.� <br />GJ?�C� r1 °'� C.: �/ C^<< ✓ �t c- i c � <br />/ � � � <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 certify that 1 have read and examined fhis applicafion and know fhe same to be frue and <br />correct. All provisions of laws and ordinances govern�ng fhis fype of work wil! be complefed <br />whefher specified herein or not. The granting of a permit does nof presume fo give authorify to <br />violate or cancel the provisions of any other state or local law regulating consfrucfion or the <br />pertormance of construct�on. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />Date <br />FEE <br />