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ELECTRICAL PERMIT APPLICATIQN <br />CITY AF EVERETT PERMIT SERVICES �, ,,�3„bs <br />3200 CEDAR STREET, EVERETT, WA 98201 ����6���5 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� <br />�jG�-- /l,'� r:.3,'7tc�l�z,:,j <br />� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />-S ! riJ G <br />Electrical Contraclor <br />Mail Address <br />Mail Address <br />f;tc�� <br />Mail Address <br />City <br />Ciry <br /><<� ���'- j�1,��- �'•.�,��-. <br />Ciry <br />,_ �,� �,'�� � s ��� S t 2 J <br />Stale License Number <br />=� -� !� /2� ss / 0 7 c9 T; <br />Proposed Use of Building <br />Staterip <br />Slate/Zip <br />SlalelZip <br />Conlracl Price of Work <br />Conlact Person (Plan Review) <br />Descriplion of Work to Be Done: ����> -z�`�� �' L��� �C ��.��'t— <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CA9LE. <br />CITY OF EVERETT LOC. �t SALES TAX COUE IS 3105 <br />1 heret; certi'y Lhat I have read and examined this applicaGon anC know the same to 6e lrue and <br />correcl. A/l provisions ollaws and ordinances govenung thrs f}�pe oI work will be completed <br />whether speci6ed herein or noL The granting ol a permd does nof resume fo give authority to <br />violate or cancel fhe provisions oI any ofher sfate or locallaw reguPting construc6on or the <br />perfortnance ol cons6uc6on. That 1 am aulhorized 6y the owner ol this propeity fo perlomi the <br />�voik !or �vhich .��pGcation is rnade and I compty wi(h the Sfate Confractors La�v f8.27 RCW and <br />296.200 bt'AC. <br />Si�naWrc <br />FEE <br />1,. ()��Oln'Ol`� <br />Phono <br />Phone <br />Phone <br />