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ELECTRICAL PERMIT A�PLICATION <br />CITY OF EVERETT PEI�MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.,� % / � ./ 1�_. i_, i.!,� ,. C Li �.�� � ` <br />PROJECT ADDRESS <br />�' ,;� <br />I %� (' :� �A�--f <br />Owner Mail Address <br />Tenant <br />�i <br />�i �'_ � <br />. �. � � jlcl�;�c.ti) <br />Eleclrical Conlraclor <br />Mail Address <br />�.;i^� �.,I� <br />Mail Address <br />�r�,-� ���1�.. �. .<i �_; �� �} L <br />Slalo License Number <br />Pro�ased Use of Building <br />Ciry <br />Cily <br />!- � v v �,�.,,9 :.t1� <br />Cily <br />Description o( Work l0 6e Done: � �` �-� '" "' � ` - � � i � "� � L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily thaf 1 have read and exnrnined fhrs ap��licafion and know fhe <br />correcf. All provisions o/ lau�s and ordinances govennng this (ype o/ wcrk w� <br />whether speafied herein or noL The granfing ol a pernut does not presume <br />violafe or cancel fhe provisions oI any other sfa(o or local law regulnfing con <br />perforrnance olconslniction. That 1 am aulhaized by the o�vner ol (his prop <br />work lor which application is made and 1 compty �rith fhe Sfafe Contracfors L <br />296.200 W�C. <br />/ _�i � �' <br />-..< _�__-- <br />S1gnoNre Dale <br />Slale2ip <br />SWte21p <br />)h �� <br />., c �:. % <br />SWte/Zip <br />� c-�, !� �y� �% <br />Conlracl Price of Work <br />Contacl Person (Plan Review) <br />Phone <br />I'hone <br />Phonc <br />J ti�.. r1 „ .. .. � .� <br />� to 6e tn�e and <br />complefed <br />�e authonty to <br />lion or the <br />o perlonn (he <br />8.27 RCW and <br />FEE <br />