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ELE�TRICAL PERMIi APPLIrATiON <br />CITY OF E�!ERETT PERMIT SERVICES <br />3200 CEDAR STREET EVERETT WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org /`�� 3'�%� <br />APPLICATIONS ARE ACCEPTcD FROM 8 AM TO 4 PM <br />) � -� <br />�!"� 7C7 / ,fJ.(� �. /l.Q-0 �L / i <br />PROJECT ADDRESS <br />/.�Cl�l S ���� <br />Owner <br />� <br />_1����<�.�rc <br />Tenant � <br />� <br />� ,� /,:' <br />'u/ '0< <br />Eleclrical Conlractor <br />State Licenae Number <br />Proposed Use o( Building <br />A1ail Address <br />Address <br />Atail Address <br />Description of Work lo Be Done: _ I�_!� �'i� �'�' `�_ <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOC�L SALES TAX CODE IS 3105 <br />City <br />Cily <br />City <br />State/Zip <br />State2ip <br />Slate/Zip <br />�0 6o i-oo 6 <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />I hereby certily that 1 have read and examined this applicalion and know the sarre fo be trua and <br />cor�ecL All provisiens olla�vs and ordinances goveming this fype o( work will be completed <br />whether specilied herein or noL The granling o/a permit does not resume lo give aidhonty to <br />violate orcancel fhe provisions o/ an}� other state or IocaUa�v reguPting construc6on or the <br />per(onnance ol construcfion. Thaf 1 am airthorizad by the o�vner oI this propedy fo perlorm the <br />�vork Ior which applicafion is made and 1 comply �ri(h fhe Stafe Confractors Law 18.27 RCW and <br />296 200 W.� �. <br />FEE <br />I /� � <br />C�c�t -doG <br />Phone <br />Phone <br />Phone <br />