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�o� S� � <br />PROJECT ADDRESS <br />Owner <br />Eleclrical Contractor <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT RERMIT SERVICES q_a9-�9 <br />3200 CEDAR STREET, EVERETT, WA 9820 i Co%9� �� � <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM n� � <br />"v���rv ��- <br />��G� �/o � <br />Mail Address <br />�f�`r�� ��� <br />�— Mail Address <br />�� �� <br />Mail Address <br />1��1�L�/ 92� 4 D <br />Slate License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWcILINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� <br />City <br />City <br />�vv��v <br />�Sa <br />Slale/Zip <br />�S 5�zs- <br />State,'Zip <br />Phone <br />Phene <br />� �G�u1L� yg'ZO/ `fZs-.ZSZ-/7� <br />Cily State2ip Phone <br />`�l5/D , o 0 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi/y that I have read and examined this applicafion and know the same to 6e We and <br />correct. All pruvisions o(laws and ordinances governmg th�s type of work wrll be completed <br />whether specilied herein or not The granting ol a permd does not presume to give aufhority to <br />violate or cancel th,e provisions o/any otherstafe or/ocal law regu/ating construcfion orthe <br />pedormance of construction. That I am aufhonzed by the o�vner o/ this property to perform the <br />work /or whid��epplicalion is ade and I comply wi(h the Sta�e Confractors La�v 18.2? RCW and <br />296.200 W -. <br />�. �;�u� � ��'� 9� � �9 <br />,EC�4G� �iZ � <br />FEEf/ <br />7�87.�0 <br />