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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVER�,�'T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �� �� �,�in �-�� I V 1�J�-1 ��O�l� <br />� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />� <br />a,� � �� < <br />Mail Address <br />Electrical Contraclor Mail Address <br />StA1`U � I N �bi.� � � � � 1 <br />S — <br />Propose Use of Building <br />Description of Work to Be Done: <br />%v'�r� <br />Gty <br />� <br />Cily <br />� <br />Cily <br />q„as_iz <br />� /zO�f=-l�`7 <br />l� qg20 <br />Stale2ip <br />- ev�. <br />Stale/Zip <br />� l,�.V✓� l�l� 1� , (%- <br />State2ip <br />d� <br />^ ,,,^\ �� <br />� '/('X'1 <br />-�--y.. _. <br />Contract Prica of Work <br />Phone <br />Phone <br />�� � <br />(��h�26� i I <br />Conlact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY 01= EVEREIT LOCAL SALCS TAX CODE IS 3105 <br />1 hereby certily that I have read and examined fhis application and know the same lo be frue and <br />correcl. All provislons of laws and ordmances goveming this type o( work will be complefed <br />whether specdied herein or noL The grantin� o( a permd does not presume to give aufhonry to <br />viola(e or cancel the provisions ol any ofher state or local law rec�ulafing construction or the <br />penorntance of consWction. That 1 am au(ho�ized by the owner ol this property to peAorm fhe <br />work lor which applicafion is made and 1 compty wifh the State Contracfors La�v 1Q.27 RCW and <br />296.200 WAC. , / <br />FEE <br />��a�-�Z-�- <br />