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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERPi�IT SERVICES <br />3200 CEDAR STREET, EVERET I, WA 98201 <br />425-257-8810 - �AX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'�� d 0� ���`Y�Jtiu tn JG�I S� �( <br />PROJECT ADDRESS <br />Owner <br />iv c,i� L�.hzl <br />Mail Address <br />titail Address <br />Elecirical Conlraclor Mail Address <br />}�h o E� r� f s 9 Z j NG! <br />Slate License Mumber <br />��G�"�i� ( <br />Proposed Use of Building <br />Cily SWte/Zip <br />'7 � 7 �iK�� G- <br />rren c:.r� J�- <br />Citv SlatelZip <br />;i( ad ut�� F Pr <br />Ci�y <br />c �; <br />State/Zip <br />(7Cv✓ <br />Contract Price of Work <br />Phonr. <br />y � z,� a <br />�L r 3Y� yi <br />Phone <br />�/LS ��60�e <br />Phone <br />Contact Person (Plan Reviee+) <br />DescriptionofWorktoBeDane: l� �-t ����f�'l�" n� ��`='�"� V''�'(_SC(✓r+t� <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 3705 <br />1 here6y ceAi/}� that 1 have read and examined this applicafion and kno�•, the sarne fo 6e true and <br />correct All p�ows�ons ollaws and ordinances goveming this type oI work will Ue completed <br />whefher specmed heiein or noL The granting o/ a permd does nof reswne ;o give aufhority to <br />violate or cancel fhe provisions o(any other stafe or localla�v reguPtin9 construcfion or the <br />performance olconsfruc6on. Thaf I am authorized by the ownerol fhrs property fo perform the <br />work lor which applic� fion is made and 1 comply wifh the Statz Confractors Lau� 78.27 RCW and <br />296.200 WAC. <br />�� �- jo • uS <br />FEE <br />