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ELEGTRICAL PERMIT �PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX A25-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />r� �/' ` y� C� c' �� � `. l✓ � 1�` v� ci'{_ l� <br />PROJECT ADDRESS <br />Owner <br />�?l� �,�,S���ti,s�� ���5��.�.q <br />h7ail Address <br />Clty <br />���t�`�� �� �$ �`IZ���33 <br />Slate/Zip Phone <br />� ��__�_- <br />Tenani Mail Address Clly Stale/Zip Phone <br />� IIL�.w1�.W.� �`��-C`'V�C_ I1��`I ��lL Ll�`'���1' ��4L�`-Vl1Ai�L� tVM� 1VPID ���CJ%�t1�O/� <br />Eleclrical Contraclor Mail Address Clty � Slale2ip Phene <br />�f����Gtl'�1�-��1�7� �G1,� �— ��- O;3 <br />Stalo License Num6er <br />Proposed Use of Building <br />Description of Work lo [ie Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT t.00A� SALES TAX CODE IS 3105 <br />Conlract Price of Work <br />Conlacl Person (Plan Reviow} <br />1 h^re6y certily fhaf 1 have read pnd exanrined this applica(ion and kno�v fhe same to be fnie and <br />coirecL All provisions olla�vs and ordinances governing this type o/ work will be complefed <br />whe(her speci�ed herein or noL The granting of a pemid does nof presume to give aufhonty to <br />violate or cancel fhe provisions o/any ofher sfafe or local law re�uleting consWcfion or the <br />peHomiance o/ constiucfion. 'fhaf 1 t+m authonzed 6y (he mvner o/ fhis pwperiy fo perfomi the <br />worfr !or �vhich application is mado and I comply �rifh the Slafe Contracfors Law 18.27 RCW and <br />296.200 WAC. � <br />�' <br />FEE <br />�� <br />�I�, D <br />� <br />L <br />