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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �VA 98201 �b � 7��y <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />� oyia-oo� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />i'�. _� , . _%1�( <br />�. �:' 1 �` �' i_- i`��r r-'_i= L= i �.i <br />PROJECT ADDRESS <br />�T C . (; .-'_ <br />I—' `iJ �- I � /—� �L--�\. ,/�h'�! �<�L��-"/`.i.� � '��" i��- �� _��.� , <br />Ownef MailAddress City SWte/Zip P,7one <br />I <br />`�� ,d h1 C <br />�125 .s 55-L�_��� <br />Tenant Mail Address City State2ip Phone <br />�Z._� %J L -C rC' =` <br />N�� �11f�z�N ,a�o3IC IC��s� S�- f-� �=��z 7 ��.+- �f,?c�' ����,-�✓z-c <br />Electrical Contraclor ldail Address Ciry SWte/Zip Phone <br />�'1 r�;r�s�vs c_�;�i� <br />State License Number <br />1[�/Slfil.J r �� i,��l'r /�f<<�/V �_�(� (�� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />L <br />` <br />�� <br />'? � C <br />Contract Price of Work <br />Contact Person (Plan Review) <br />� <br />� _'�� � 7 LI /� � L-_ c . �•, I � I C, I �i " � _ �., {.- _ �; �- I ���' I � ,-4C- ,� I , % �_ �-,'� !,�, <br />-- � - - - <br />NOTE: WIRING IN NON-L�WELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceRify that 1 have read and axam�ned fhis application and know the same to be true and <br />conect. All provisicns o(laws and ordinances goveming this type oi work will 6e completed <br />whether ;pecified herein or not. The granting of a permd does not presume to give authority to <br />violafe or .ance/ the provisions ol any other state urlocal law regulating constructron or the <br />performar,ce ol construcaon. That 1 am authorized by the owner of this property to perform the <br />vork for which application ismade and I cemply �vith the Sfate Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />� i� <br />�(� l I / -} <br />'` � � � \ (i" ` � - " 1 i i . l - l � — � �� <br />FEE <br />C C'-1 l G GO�S� <br />? <br />