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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES � va ��� <br />3200 CEDAR STREET, EVERETT, WA 98201 / <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � D 7��� �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��� �a�� �� 1/L1QI iI1dZ I A A'(/F _ <br />PROJECTADDRESS 1�i <br />_il" d E <br />Owner <br />Tenant <br />Electrical Contractor <br />State Licenae Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />City <br />Ciry <br />City <br />(,cdi /..y�>o 3 yJs,;� <br />_� State2ip <br />StatelZip <br />StafelZip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work to Be Done: RU�^ �GEC �ZIC / Iy ��L�,-`'1 %�7� fl/1U5F THt <br />1)�rAcf�ICD CyfR�IC�,�" <br />NOTE: WIRING IN NON-DWELLINGS I� REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERCTT LOCAL SALES TAX CODE IS 3705 <br />I hereby certily tnat 1 have read and examined this applicafion and know (he same to be true and � U�(�'�— �`-�3 <br />corract. AI! provisions of laws and ordinances goveming this fype ol work will be comp/eted <br />wheffrer spealmd herein or noL The granting o/a pennd does not presume to give authonty to <br />violafe or cancel fhe provis;ons ol any olher sfafa or local law regu/afing consfrucfion or the <br />performance of construction. Thaf I am aufho�zed by tho owner of this property to pedorm fhe <br />work (or which application is made and I comply with the State Con:: actors Law 18.27 RCW and <br />296.200 WAC. <br />_ . /i / <br />Phone <br />Phane <br />Phone <br />