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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�' � S/� j%�4�i✓ i�l/� � d�t� f/- <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />��l/1 (�ch%5 �:�cl/%/D� � <br />Mail Address <br />�zcC�/s�l�� � <br />Mail Address <br />Electrical Conlractor Mail Address <br />��LC iS i�C `1Gs%�� �J <br />State License Number <br />Proposed Use ot Building <br />City <br />City <br />StalelZip <br />StatelZip <br />Phonc <br />Phone <br />�� �L� .�37���5!!S�✓1yr„v�✓c«/ <br />Cily <br />. ��% � � � U <br />�- <br />Description of Work lo Be Done: ��< < c-F/�i f(' % ://1 C Ci/ i S <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 31Q5 <br />Stale/Zip <br />� '7uv <br />Conlract Price of Work <br />✓i•C�: `C'GC/S��c/ <br />Conlacl Person (Plan Revie�v) <br />� �c � (-�( i �i9 C-� % <br />I hereby certily th�t 1 have read and examined fhis application and knoro 1he same to be frue and <br />conecL All prowsrons o/laws and ordinances governing this t}�pe ol �roik wdl be cornpleted <br />whether specdied herein or not The granting o/ a pernut does not uesume to give authonty to <br />violafe or cancel fhe provisions of any other sfafe or local law regulating construclion or the <br />peAonnance o(consfniction. That i am aufhorized by fhe owner o! fhis property to pedorm (he <br />work lor which appliwtion is made and 1 compty wifh fhe State ConVacfors La�v 18.27 RCW and <br />296.200 VI�AC. <br />) �% "l <br />, ;� <br />, �� � � � _ . . ,��� - i- �. � <br />FEE <br />Phone <br />�QY7�0' �—UJ <br />