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ELECTRICAL PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES 9_ �9-DS <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-0810 - FAX 425-257-8857 - www.everettwa.org �,�%O50 �—� �� <br />APPLICAl10NS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CAROS ARE NOT ACCEPTED <br />� <br />�.�'�C�x.t�.t��. � .-,�: ��s,., , <'�F � �i� <br />PROJECT ADDRES <br />Tenant <br />R1ail AAdress <br />Mail Address <br />( Cu;,l_�i� �Vri.. `"1 �5 <br />Clry State2p <br />Cily Slale/Zip <br />P�o � <br />Phone <br />IYC�'7c� 4. '�Mi�� <br />ElBttnc0l Conifactor Matl Address City SlatelLp Fhone <br />Slale Ucense Number <br />CQ„ � .ji_�,�+-( <br />Propose Use of BuAding <br />� i7 <br />Descnphon of Work �o Be Done /�c'�C- <br />NOTE: WIRING IN NON-DWEL LINGS IS REQUIRED TO <br />E3E IN RACEWAYS. MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 <br />���" �� c <br />Contrad Pnce of Work <br />Cuntact Person (Plan Rewew) <br />1lrereby certdy thaf 1 hava read and exarnmed Ihis apphcahorr and know fhe same fo btt fn�o und <br />conecf .411 prov�sions ol laws anAord�nances gover,:mg fhis fypo o! wod: will bo c»mplefeA <br />whelhor speahed he�em or not Tho granbng o! o pomvf does nof rosumc fo give authonty fo <br />vio�afo or cancr.l tho provisrons ol nny ofher sfafo or local law ieguPabng cnnstn�ction or the <br />pr.rlornrance ol mn.shuchnn 7hnf 1 arn aufhonzed by tho owner o/ this pr�perty lo peAo�m fhe <br />wor6 /or �rhir.h apphcation is rnade and 1 comply wifh fhe Sfafe Conlracfois Law 18 27 RCW ard <br />296 200 WAC <br />FEE <br />