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ELECTRICAL PERMIT APPLICATION ',, <br />CITY OF EVERETT PERMIT SERVICES � <br />.} � , '� i-_ <br />PROJECT ADDRESS <br />� ,� ,, c �.� <br />O�vner <br />�� ... � \ �T .1 `'_ '.�'„ <br />Tenant � <br />� _ t" <br />_,;—. r r <br />�_ �, ���r 1 n � _. c <br />Electrical Contreclor <br />3200 CEDAR STREET, EVERETT, WA 98201 5` f/ _O9 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Ptd <br />� <br />— �, .� � — ,'• <br />Mall Address <br />—�-'"-\ `, �y']'•,(`� 1 <br />Mail Addresa <br />"��,C' l � ,. �1t"t"1 `1 <br />Mail Address <br />—., � � `r t, � .�: _ , ^ `-.: <br />J. }_ . �..._ .� � ��_ _ <br />Stale License Number <br />Proposed Usa of Building <br />! �;,, , ' 1. <br />cu—T -� <br />.1 �� 1��� �o�l"' <br />� Cily <br />��. a:� � <br />City <br />� �,`' <br />S�ate2ip <br />S�ale2ip <br />�O�aS-ado I <br />_�;�'•��1�_�`_.!� <br />Phone <br />Phone I <br />. •, �! <br />� '� �-1 -r L\� <br />SlatefZip Phone <br />:.� � :._- ,_� J'��� <br />Conlracl Prica of Work <br />Conlact Person (Plan Review) <br />� . <br />Descriptian oi Wotk to Bo Oone: Y r--� U-_j )1' �)'(7 '- i-'�� t, n,�'1 C� 11 i l� `1 (; �,� .�' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAlES TAX CODE IS 3105 <br />I hercby r.edily fhat / have mad and examined Ihis applicati�n and know O�e same fo be We and <br />correr,l. All pravisions ol/aws and ordinances governmg th�s type of �ti-ork �vill be completed <br />�vhellicr spea6ed herem or not The granfing o( a pernnt dcos nol resumc lo give aulbonty to <br />vio/ate or cancel the provisions of any otber stafe or local law reguPting construc6on or the <br />peAormance ol consfruclion. Thaf 1 am auf6orized 6y the owner o! this �ropzAy to peAorm fhe <br />worR lor which application is made and 1 comply with the Sfale Contractors Law 1EG 27 RCW and <br />296.200 WAC.1 <br />FEE <br />—} ��� <br />`\ 1. <br />�GJ�`'IC S �:4,`: <br />�. ��ljl. <br />