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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 G�%D 2`-�%�� <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org Z` ��`�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_�v 3 C ab � f �i, �,�'ve.-etr w� <br />PROJECT ADDRESS <br />Ownor <br />Tananl <br />Electrical Conlrnclur <br />Slato l.lconso Numbcr <br />�3�%'_ <br />Proposed Usv o� Buildiny <br />Mail Addross <br />Afail AdJ�ess <br />Clly <br />Clly <br />a�y <br />� �Z � 3 <br />Stale2lp � 42 S�P� �/� <br />� --I�UQ 9�2 v 3 <br />Stale/Zip �honc <br />Slale/Zip Phone <br />Contract Prico ol Work <br />Contacl Porson �Plan Review) <br />Descriplion o1 Work lo Oo Don�: _�� iYl (.L� /'�0,7aM—� <br />�_�,.T— <br />NOTE: WIRING IN NON-DW[LLINGS IS RFaUIRED TO <br />BE IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 heroby certily fhat 1 h�ve read end exnmined Ihis npplicntion end know Iho serne to be f�uo end <br />corrocf. All pro��isions ol lnws and oic/innnces govommg this type o/ wo�h wlll bo complefed <br />whofher spec�GcA homin or noL Thc prunfinp ol n pornuf does nof �resume fo give aufhonty fo <br />violote or cnncol th� rovisions o! any ofher stnfo or local low regu�ating consfrucfion or the <br />porlomimice o! consPuction, Thaf 1 am oufhorizeA 6y fhe owner ol Nus property to pedom� fhe <br />work lor �vhich epplicnfion Is rnnde and 1 comply with fhe Sfnfe Conhocfors Lew 18.27 RCW and <br />296.200 WAC. _.._ <br />FEE <br />C�i�z -�x3 <br />