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ELECTRICAL PERIV�IT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl�f, WA 982U1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�, <br />/ : � �. ^ . � <br />.i�.� ��i.��<o--Cii ;1".�l <br />PRUJECT ADDRESS <br />O�vner <br />O� �p� <br />Mail Address <br />-:�.��,�'l ;�_ r.`r �, � � <br />Tenanl Mail Address <br />i S r,— : ' <br />�# ', l_.�. � � � .7`>C ' <br />City <br />Cify <br />StalelZip <br />Slale/Zip <br />/D �ab�o� <br />� o �,o �-�y <br />Phone <br />Phone <br />� J _( rC�Fl� � L���s ��C''� I�� 3� Cv'.-�y! � W� ���'��G�� �/= 5 z���iY2 <br />Eleclrical Contraclor Mail Address City Slala/Zip Phone <br />Slate License Number <br />�3��� <br />Proposed Use of Building <br />Description of Wark to 8c Done: <br />n�d� � - �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 CCDE IS 3105 <br />SSCc�L, <br />Contrecl Price of Work <br />Contacl Person (Plan Review) <br />o J c,r� u.u�� <br />1 hereby certi(y fhat 1 have read and examined this applica(ion and knmv (he same fo be lrue and <br />correcL All provisions ol Ia�vs and ordinances govemmg fhis type oI �vork will be complefed <br />whether speci(ied herein or not The granting o( a permit does not resurne to give authonty to <br />viola(e or cance! the provisions of any ofher slate or local la�v reguPting construction or the <br />per(omiance o/ construcfion. That 1 am aufhorized by fhe o�vner oI fhis property to pedomi fhe <br />work lor which applicafion is mad� and I comply �vith the Sfate Contracfors Law 18.27 RCW and <br />zss.zoo �v.ac. <br />, <br />'.' �_l ,1., _ /!'_ �G�-0 <br />FEE <br />�G � <br />•/ � L/ <br />��/� , <br />