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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 />j�.Li—� c� � �1 � ��_ S�. <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical <br />�v .�C< <br />Mail Address <br />Mail Address <br />_ 1l� <br />Mail Address <br />��<�� � � � ����� �/�l <br />Sta� License Number �- <br />� '� <br />;� �c.,;1i�� �� i2Tc��l�—,.; �.� �� <br />Proposed�.Jse of '�uilding - <br />� <br />Description of Work to Be Done: �-i'"� <br />City <br />City <br />�� <br />City <br />l �`l� �`r <br />State/Zip <br />State/Zip <br />�w��. ���?S �� <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />�,���� lr�� %:�� <br />.,-. J ,,j/,�/% ) � n , <br />i � <br />n�l—!''FF ll��'--/ `- / �-I L. /�I� �' 1//Lvs� �'��"/ ' f /Uv L i' //C � � <br />% �/%� � � ,� <br />lit�L..ki� ('��Li � ��l�Z�� '7'� �� �-�')7wi�..:, � lJ(/6�r/1 � ���'��-�., <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 I have read and examined fhis application and know the same to be true and <br />correct. All provisions of /aws and ordinances governin� this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority fo <br />violate or cancel the provisions(of any ,¢ther sfate or local law regulafing consfruction or the <br />performance of construction, That ! a/p aufhorized by the owner of this property to perform the <br />work for w/�h applica`iiqri is;�ade aqd 1 comply with fhe State Contractors Law 18.27 RCW and <br />296.200 WA t�. i` I ?l .' (l <br />FEE <br />Phone <br />Phone <br />� � �y- � <br />Phone <br />,; <br />� � �Y , � <br />,-j� <br />p <br />