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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wwHr,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />' ` � �"' ./ c L'-� � � �L ► ir '� � L(� C.l.� ►4 � ��j�l �� <br />PROJECT ADDRESS <br />Owner <br />�z� i � ! <br />Tenant <br />Electrical Contractor <br />Mail Address <br />���� <br />Mail Address <br />T�-►Co � � <br />Mail Address <br />City <br />City <br />�3�sb- i�; <br />City <br />�-� i� �. ( � ���� <br />State License Number <br />, � 1 �� �i'l?�i2 ' <br />Proposed Use of Buildmg <br />Description of Work to Be Done: ( j,,�z � i Z\C �-L `J �ZC'� <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 />�� <br />State2ip p�e <br />� ��(��T� �J� � � 2�� <br />State2ip ph� <br />�� �f� IV -�-�{S� � (�'�P� ��2'lc <br />State2ip Phone <br />�� Z ��rJ <br />Contract Price of Work <br />Contact Person (Plan Review) <br />� 1 � C � ►-i �ILI( <<IZ� <br />l hereby certi/y that / have read and examined this application and know the same to be true and <br />conect. All provisions of laws and ordinances governing this type of work will be completed <br />whether spec�ed her�in or not. The granting of a perm�t does not presume to give authonty to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. Thaf l am authorized by the owner of this property to perform fhe <br />work fo� which applicafion � e and I mply with the State Contracfors Law 18.27 RCW and <br />296.200 WAC. %� , /� <br />._.. _ .,� _ �_.�___ -_ <br />� �___-� � <br />�/ �/� <br />FEE <br />��v�o <br />�I���—��7� <br />