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ELEGTRICAL PERMIT APPLICATION <br />CITY OF EVERETT FERMIT 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 />�`J� Pl/�/l� %��j/1� �i��/�/T'- <br />PROJECT ADDRESS <br />Owner Mail Address Ci�y <br />State/Zip <br />(.�a to4-/33 <br />y � a � -09 <br />Phone <br />Tenan� Mail Address City SlalelZip Phone <br />� 33�� l�ih�//-Cv�>/� y h <br />�VirfdPl����r �r�� ��wr P�� �'G �� �1 /%<rr-.�� -w� y�o,l �#�2 -�r� <br />Eleclrical Contractor Mail Address City State/Zip Phone <br />IN����l �'`7 .Z �f�T <br />Slate License Number <br />�� / !/ /'/ � <br />Proposed Uso of Building <br />i <br />Descriplion of Work to Be Don�: ��� L' C'C�l�! � <br />y/f�i��✓ 2 �-"%�Y� �i rcu� /s <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAY5, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby certily Ihal 1 have iead and examined Ihis <br />correcL AU provisions ol laws and ordinances gov <br />whether specilied heiein or noL 7he granting cl a <br />violate or cance! tl�e provisions ol any ofher sfate � <br />perlorrnance o/ cons6uc6on. That 1 am aufhonzec <br />work lor �vhich applicafio ris made and I comply w <br />296.200 WAC. . <br />/ �/ � <br />�/_�'� � �_ <br />C .�/%' � � �// , <br />O �D <br />�ti�� <br />CoNracl Price of Work <br />ConlaclPerson (Plan Review) <br />and know fhe same to be true and <br />ype o/ work will bo complefed <br />� nof presume fo c�ive aufbonry fo <br />�ec�ulating construction or the <br />er ol fhis properly to perform fhe <br />Contractors Law 18.27 RCW and <br />�?�'O <br />o f � r� <br />FEE <br />� I (,�-t ' l 5 3 <br />