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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.everettwa.org <br />APPLICQTIONS ARE ACCEPTED FROM 8 AM TO 4 PM (� �, a�) .Z <br />�l�.oy�ol2 <br />,�`z/� ���,t�� � �i <br />PROJECT ADDRESS <br />' �.,��� 3zs�79¢�,/ �%i.e s� .f�a�.�� �a f�5`/ 2��d"1�'�sB <br />OWner MailAddress City StalelZip Phone <br />Tenant <br />Matl Address <br />City <br />SUte/Z1p <br />Phone <br />�� ��ii 31��7 J�fu� l�v/ SF ,f�o..-.,r�l i � Yl�SI 206 P3/z�sj' <br />Electdcal ConUactor Matl Address Ciry S�ale/Zip Phone <br />,�v�1�dF�cvis�i� <br />State License Number <br />Proposed Use of Building <br />Descripticn of Work to Bo Done: <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 3105 <br />Contract Price of Work <br />Contad Person (Plan Raview) <br />I hereby certi(y that I havo read and examined this application and know the same to be true and <br />correct. All provisions ol/aws and ordlnances goveming this type of work will be completed <br />whefher specified horein or not. The granting o/ a permit does nof presume 10 glve authority to <br />vlolafe or cancel the provisions of any ofher state or local law regu/ating co^strucfion or the <br />perlortnance of consirucfion. That 1 am aufhorized by the owner of this proN�� ty fo pertorm the <br />work Ior which application is made and 1 comply wifh the State Confracfors Law 18.27 RCW and <br />296.200 WAC. <br />-3 - <br />FEE <br />5D °� <br />�IZd�-{-OIZ <br />