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ELECTRICAL PERMI�' APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE-ET, EV�RETT, WA 98201 ���dj-QG� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P'1 C D�D .3 �0�� <br />�".I '�a r� I, l� r ��i` <br />PROJECT ADDRESS <br />�Ci��l��, II'ulil,�'i,�t � Il.� I�i N�'!- II��I � I�:��iCl� � i„1� ����)Llr �`��)'?J) ��� (,�'1�1 <br />Ovmei Mail Address Cily Stale2ip Phone � <br />� \ <br />i �L�/V� ���1 l���l�'L �L ��l �. ��i�,� ��)� �(�i�l��-i—;.lr �i ��1' � �.vylli� �`.iMl �� )�L �`1�`)),Yj�� L'l�� �/ <br />tenan� Mail Atldress 1 Ciry State2ip Phone <br />��I���iI ��,- t�„�, i� -Si.�"�i �, i�. I'�� i�uiJ���,i L�1i �f�l��� i'I�'�)Y�� L�`��� <br />Electncal ContraClor Mail Atltlress Cily Slate/Zip Phone <br />���� �� ���,�„-,,,, <br />Sta1e License Number <br />Proposr.tl Use of Building <br />Description of Work to Be Done <br />NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACFWAYS, MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 3706 <br />i� �.� � .)`i <br />91- � , <br />Contract Pnce ol Wo�k <br />�ilr� I ��el,',( <br />Conlad Perso , �Plan Reviewl <br />I If�, ; � (' (' � <br />FEE <br />l horchy r,ortdy fhnl 1 Irave �ead nnd marnmeAflus app6cafron and know the same Io he 6ua ond <br />rnnecf All p•ov�sions ollaws nnd orUinnrrcos govorrrng this type ol �vorM wdl Ge complefed <br />�rhefhm spor A�ed Iror�rn or nof The yranf�ng o( n porrnd Aoes not rosume to o�vo aufhorrty ro <br />v�olafe or ca�rol fbo prov�s�ons ol nny nfher sfafo or loca� law �eguPtmg consfrucfun or fhe <br />perlormance ul consVud�oq Tiraf I artr authonzed Ay fl:e ownei ol �his p�uperty lo perlorm fhe <br />work !or whrCh applrrnfwn is rnade arrd I compty wRh !he Sfafe Confracfv;. �_aw 18 27 RCIh' and <br />?96200 WA� . <br />� C <br />J 'J � <br />Ed9o3 09�1 <br />