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J <br />ELECTRICAL PERMIT APP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ( ( — 0 ��'"� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L=�O 6��'oy3 <br />_ , � <br />> �- ,� <br />LL , c �ib(� , <br />PROJECT ADDRESS <br />i� <br />�',i�� �-,i, �. :� �=�' . . <br />Owner Mail Address <br />Tenant <br />�, � 'l�t :. .. � <br />Electrical Conlraclor <br />State License Number <br />��Iri(� <br />Proposed llse of Building <br />Mail Addmss <br />�vlail Address <br />Descriplion of Work to Be Done: ��� �_1l 4 � <br />�-;•� ,�,� �� 1�.� 11 <br />Clty <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 />Cily <br />Stale2ip <br />Stale2ip <br />Cily Stale2ip <br />�� — <br />�ii l' UU <br />Conlracl Price of Work <br />P <br />> <br />���'�i(.7i��:�l� <br />Phone <br />Conlact Person (Plan Review) <br />I here6y certily that 1 have �aad and exarnined fhis applicafion and kno�v fhe same to be frue and <br />conect. All provisions ollaws and ordinances governme� this f}�pe ol �vork wiil be comple(ed <br />whether speci(ied herein or noL The granting ol a permd does not resurne to give aufhonty fo <br />violafe or cancel fhe Provisions o/any other state urlocal la�v reguPtiny construction or the <br />perlormance ol consfiuc(ion. Th�f I am aufhorited by the ott-ner o( fhis property to perforrn the <br />work fur which applieafion is nmde and 1 contpl} wifh (he State ConGacfors Lan 7f7.27 RCW and <br />29G.200 WAC. <br />1 <br />- +i <br />FEE <br />Phone <br />Phone <br />