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. <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES � 8`0 <br />3200 CEDAR STREET, EVERETT, WA 98201 �" � <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C 6 7 D ���q <br />I <br />APPLICATIONS ARE ACCEPTHD FROM 8 AM TO 4 PM <br />, , c� 1 v �'' � o � <br />,�fi%. � �� < (� i , /�r'/<'c_ f l l 'C � � �'/�� � � •�� �� � <br />PROJECT ADDRESS <br />i ��1 � f <br />//n �d<''"� �t c, d�- �CL� %�l'J rt'� S ✓ .S Ct� �CL• p1t�G d-tf% �ti�%� <br />Owner Mail AdAross City SWte/Zip Phone <br />�l�- �,@ "'3r3 O <br />Tenan� <br />Eloclrical Conlrar,lor <br />Mail AAdress <br />M.il Address <br />Clty <br />City <br />Statn2lp <br />SlatelZip <br />State Licenso N�mbcr Contract Price of Work <br />�'!',t ('(�� ' �1�'�� ��i//�� S /��C'-�� �ZC�/iX''c".C'� -- <br />Proposed Usc of E3uildin9 Conlacl Person (Plan Review) <br />Doscriplion o� Work lo �c Dune: /`� �/ /1" /'�'�� ��' "�C����'r t--_ <br />NOTE. WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA.' CODE IS 3105 <br />I hereb�- ceriily Ihet I have reaA and exnmined fhis application and know the same to bo truo enA <br />conect. All provisions ollaws anA nrAinances yoverrony th�s type o! work will bo complefed <br />�vhefher specilied he�ein or noL The granfing ol a pernuf does nof pr�sume to give aufhonfy lo <br />wolnte or cancel fhe Inovisions ol mry ofher stafe or local law regu/afing cunsfruction or fhe <br />perlormance o! consfrucfion. Thaf 1 ant authorized by the a�sne,o/fh�s property to pe�form tlie <br />�vork !o� which opplicafion is made and I comply with fho Sfafe (.onhactors Law 79 27 RCW mid <br />296.200 W'AC. <br />� �� , t � ,1-( � <br />1;��. ' � � � <br />FEE <br />F o�c� � 9 5 <br />Phone <br />Phone <br />