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ELECTRIC�4L PE�MIT APPLICATlON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,� �� 1� <br />�; �r �<< ��'-�N' r � � �^C It � ��0 3 <br />PROJECT ADDRESS <br />,c�,�, l _.� <br />ownor <br />Tenanl <br />� �iG�j H I ��( f <br />htail Address <br />fAa���l AAdres; <br />Cily <br />Cit, <br />��/1 �Y`��r <br />Electrical Ccniractor h;ail Address Crty� <br />Stale Licanse <br />1 <br />i <br />��� , � <br />Proposed Usc of Quilding <br />Description of Work to �e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />GTY OF EVERETT LOCAL SALCS TAl( CODE IS 3105 <br />Sfate Zip <br />Satc'Zi, <br />State/Zip <br />Contracl Price of Work <br />Conlar,tPerson (P�ar'2evie�v) <br />� <br />I heieby ceddy flm7 I have read and examined this npplicaffon and know the sanie to be true and <br />con�cL All provisions ol lnws and ordinanres govwnmg fhis fype o/ �vo�k �vill be completed <br />�shether specilied herein or not. The granfing ol a pennrt does not presurne to give authority to <br />vielate or cancel Ihe provisions ol any ofher sfafe or local law regula6ng constructron or the <br />perlormance ol constn�ction. That 1 arn aufhorizeU by the otsner ol fhis preperty fo per�orrn the <br />�vork lor �vhich �pplica(ion Is rnade and I cornpty �vilh the State Con6acfurs Law 78.27 RCW and <br />'19& 200 WAC. <br />� <br />/�-o <br />yz � <br />1��2 <br />Pnone <br />Phon� <br />Phone <br />FEE <br />� <br />��- C "� G `a � � >J <br />