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ELECTRICAL PERMIT' APPLICATION <br />CITY OF EVERETT PERMIT ��ERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�=�! I � `.= _.� , . .�. �,:, � ��e �� � � L-i'� <br />PROJECT ADDRESS <br />Owner <br />�� <br />� �.�.,.: <br />Tenanl <br />� • ,�:��r_ � <br />Eleetr cal Conlraclor <br />�Z� (( � � �_� <br />Slate Lic nse Number <br />�;� �, �, <br />Proposed Use o Buildir <br />Mail Address <br />A1ail Address <br />;r . . . <br />Mail Address <br />Description of Work lo De Done: `�� >' V`z� ����� <br />City <br />��l�U <br />�ViA - lJ. �� <br />` Cily <br />`� �; ( �x� <br />.� � <br />Cily, <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 certi(y fhaf I have read <br />correcL All pravisions olla�vs s <br />whe0�er specified herein or not. <br />violateorcancelflie provisions <br />peAomianceolconsfiuction. T <br />�vork lor which applic (ion is mt <br />296,\ 00 WAC. <br />,, �,� ' � <br />Stale/Zip <br />.�,�,et{�� -- <br />. � � �� <br />Phone <br />� ; S z- =�;'O( <br />J� <br />Phone <br />7��>5� �(�ti-.j���- 5 �l �c <br />Slate2ip Phone <br />`� �� <br />: � ,���� <br />Conliac: Price of Work <br />� ii�lorl 5 �G'C- �{I 1'� �7 `f <br />Contacl Person (Plan Review) <br />A(1���1cr��'�rS � <br />examined fhis applicafion and kno�v fhe sarne to 6e frue and <br />rdrnances govemmg (his type of uork will be comp/efed <br />� granfing o(a permrt does nof resume to give au0�onty to <br />ry other stafe orlocallaw reguPting consfruction or the <br />am authonzed by the owner oltlris property to perform the <br />nd I comply u�ith the State Contiactors La�v 18.27 RCW and <br />� <br />��� . �„ � c <br />FEE <br />