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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETi' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9@201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEFTED FROM 8 AM TO 4 PM <br />��� ��, �Z ��' r-�,��-' ��{�l i.�ll�G( y��Z <br />PROJECT ADDRESS <br />�z� <br />Owner <br />61 �i� <br />Tenant <br />�'x� �i�l'�'I �/l C� �'��'3 <br />State Li�mber <br />C G✓i�,��� �c:�'-( <br />Proposed Use of Euilding <br />Description of Work to Be Done: <br />�-�,- �r `��:.. �i�ef�-e�t- <br />Mail Address Cily <br />C�[3"% .S L. lL't'�=�f? <br />Mail Address Ciry <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT t.00AL SALES TAX CODE IS 3105 <br />City <br />(iu'e''fi���.' f:(9�t�c.f�- �1�'�z� <br />State2ip Phone <br />/tll�C�'!.�%c� �/L't'���3— �J2� <br />Stale2ip Phone <br />�i Jf: d�-LL�- �%'��le:-� - ��Z 5� 7U�S'(� <br />L 1 � G�'lJ GC1�{' <br />State2ip <br />� �)% N� <br />Conlracl Price of Work <br />l D/(/'fi.C�����c�� <br />Conlact Person (Plan Review) <br />1 hereby certify Ihat I have read and examined this application and know the same to be frue and <br />conect. All provisions ollaws and ordinances goveming this type of work will6e comp/eted <br />whefher spea�ed herein cr not. The gr�nting ol a permd does not presume to give authority to <br />violate or cancel the provisions o( any other stafe or local law regu/a(ing construchon or the <br />per(ormance of construcGon. Thst 1 am authorized by fhe owner of fhis propeRy to peAorm fhe <br />, .,,�ae �.,.� � �,,,,,,,i�� u,rrh rnP .sra�e Contractors Law 1827 RCW and <br />FEE <br />� � <br />Phone <br />�13C�- o�� <br />