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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 />15��� ���-<�,���� ��,��::�- <br />PROJECT ADDRESS � <br />(�.� s��lo -��� <br />� ,. � �:.n L.�.i ,` / (i �=��u �_, % �/�"> /29�u�,.so, , � �,�� �t � J�� .�� � 1,c�� � , z.� � <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />� z� t�Jf:.!' <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />City <br />City <br />Description of Work to Be Done: f� j�� �i N.� f' ; r�2n ClGI <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� ,�.� C_, <br />l hereby certify that 1 have read and examined this application and know the same to be frue and �� �'�-- ��> � <br />correct. All provrsions of laws and ordinances governin� fhis type of work will be completed <br />whefher specified herein or not. The granting of a permrt does not presume to give authorify fo <br />violafe or cance/ the provisions of any other sfafe or local law regulating construction or the <br />performance of construction. Thaf I am authorized by the owner of th�s properfy fo perform the <br />work for which application is made and 1 comply with the Stafe Confractors Law 18.27 RCW and <br />296.200 WAC. <br />' >� =�`: -�:.__._.--- � <br />.�Z_-;%'',!��/_ - -E -�``�=l � ,�2 � J � � � 2 C.j i / <br />Signature Dat <br />