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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR STREET, [VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TJ 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />.�9 ,� 3 �I b�� �'-1 L�, <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />� .���; �-- J �,� � 19 �`� <br />Mail Address <br />Mail Address <br />� �k; <br />Ci�y <br />Ciry <br />�3 �4. qg� <br />State2ip <br />SlatelZip <br />�zs- a3�- <br />uoZ� �,I <br />Phone <br />Phone <br />= �,� �.1���-, y22� ���^ s�-, �s� j , <br />Electrical Conlraclor Mail Addrcss City State2ip Phone <br />�� �; �z�- i 31 �I �� <br />Slate License Number <br />S/�� <br />Proposed Use of Building <br />Descriplion of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Contract Prico o( Work <br />Conlact Person (Plan Revicw) <br />CITY OF EV[RETT LOCAL. SALES TAX CODE IS 3105 <br />I hereby certi/y fhat I have read and examined fhis applicafion and kno�v fhe sarne to Ge true and <br />conecf. All pmvisions ol;a�vs and ordinances govemmg this type ol work will be completc-d <br />whether speafied hereir, or noL The �ranting ol a permrf dees not re�sume to give aufhonty to <br />violate or cancel the provisions of any other sta!e or IocaUaw reguPfing construr.fion or fhe <br />performance o/ consfrucfion. Thaf I arn aufhorized 6y the owner of Ihrs properiy to perfonn the <br />�vork lor which application is maAe an mply wr(h fhe State Confracfors la�v 18.27 RC W and <br />296.200 WF�C�� /� ;: � �� � — � <br />, ' / ,�,� n��,� � ' � S <br />��c <br />Siqnature / oaie <br />FEE <br />E o5c5- o�. I <br />