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� <br />t <br />i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l lZ colb,i .4✓e Ev�tt <br />PROJECT ADDRESS � <br />Owner <br />Tenant <br />ol5on 7%Z �-olG„ �✓� <br />Mail AOaress <br />� <br />Mail Address <br />City <br />City <br />�/oo��a6 <br />�.-a-�.�v <br />2 `�� <br />✓9. ��Zo i Nis2s <br />Stale/Zip Phone <br />SlatelZip Phone <br />tk�nne%s�;, e%cl'�'•'� ;�� �3� N�� /��r� �r1��� w,o sPt2� ��-v3s-s? <br />Electncal Contractor Mail Address � City State/Zip Phone <br />I�cnn e e�-O yy PZ <br />State License Number <br />�%�5� <br />Proposed Use of 6uilding <br />�jS ��, <br />Contract Pnce of Work <br />Contact Person (Plan Review) <br />Uescnption of Work to Be Done: �E' i✓ � 1 r� u. / �0 I' J+'� ; n; •� P�i �f?frLit I u�A,� <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 hereby ce�Lly thal I have reaJ and exanuned Uus applicalion and know flre samo to be Irue and <br />conecl. All provisons of lans and ordinances 9overnmg Ihis type oI work wdl be wmplefed <br />n�hefher specdied hei�irr or noL The gran6ng o� a pennrf does nof resume fo givA aufhonty fo <br />violafe or cancel fho provisions ol any other slole or local la�v reguPfing const�ucfion or fho <br />pedonnance o/ conslnicfion. Thal I anr aufho�ized 6yllie o�vnei o/ fhrs property fo pedomi fho <br />work Ior which application is maAe and I congNy �v�{h fhe S(afe Conf�actors La�a� 7817 RCW and <br />296200 WA� — ' .. % . .. - - <br />FEE <br />�Ibv"1- I�;ID <br />