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ELECTRICAL PERMIT APPLICtaTION <br />CITY OF EVE�ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVFRETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �� • �� �i <br />' <br />�i � � � � � ��A �J� U�_ <br />PROJECT ADDRESS � <br />C "�C' �� � � -� ' —� � � / t �� � ��L� � <br />���C c•l _�. �, L_ � I,, ) ; v� I,� �Iv— <br />Owner AfailAddress Lily Staleilip Phone <br />Ten,iN <br />! -I�i i�- C I�c�{ <br />Eleclrical Contraclor <br />Idail �ddress <br />M11ail Address <br />� <br />���:����I�'`� �l� <br />Slatr. License Number <br />�i� i ' I r � I -� ( - <br />ProposeA Use of f3wldin� <br />Uescription ol Work lo F3e Done: <br />G�y <br />Cily <br />St�te'Zip <br />Slale/Zip <br />� � L�����1 _ u� : <br />CoNracl Pricc ol Work <br />��C ) �CIC��'i Ui �t `-% / <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 />Conlact Person (Plan Reeiew) <br />1 hnreLvi certJy fhaf I havc ic�d 2nd eeamined fhis applicnfiun and know the snmo to ba fruc aiA <br />r.onec( l.II pr��visions nllmti:s and ordinances ,qoverninr� fhis fype ol work �rfll be complcfed <br />�vhelher speciGed hcroin o� noL The granfin� o� a pernuf does not presume fo give ��uthority fo <br />v�olafe oi cancel fhe provisions o! any other sfafe or bcalla�v �egulating const�ucfion or fhe <br />pe�foiniance o� consf�uc6on Thaf I arn authorized by flm o�vner ol this prcpe�ly (o perform tl[e <br />u-o�k lor which applicntion is nmAe and I comply u�ifh f6e Stafe Cor.tncfors La�v iH.27 RCIh '+nd <br />296.200 Vl'AC. <br />s' <br />FEE <br />Phone <br />rnone <br />% �� ! �� <br />j, <br />