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ELECTRICAL PERMIT APPLICATION <br />,���i /��('t� <br />PROJECT ADDRESS <br />Owner <br />CITY O� F_1�ERE?T i��RMIT SERVICES <br />3200 CEL�AR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wwvd.everettvda org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 F�9 <br />�Aail Address <br />CAy <br />StatelZi, , `� Phcne <br />i <br />� 1/�,'/I �� 4�KM /11 ut �lo ►�-�' �.�1 'S :L f; �r'% �i/ �I�"�c J 1 �y �`�_ <br />Tenant MailAddress Cily Stale/Zip fhone <br />y1f <br />f[lctJ�,�r�)�il Sx 1 3Gc� Ftl1 �1//� �r// 9�%�c/ 2S`/ 2/4/ <br />Eleclrical Conirac�ot Mail Addmss City Slale/Zip Phone <br />�y i � <br />.1'�-�!Y J.`_� /`I �� � /.1 <br />Slale I_ice�se Numbcr <br />i ��� 1 <br />Proposed Use o( Building <br />DescriptionofWorkto6eDone: A!Gl%((f�ll- � �i�/i4 � 1%l�b /!_ <br />i <br />��l�r � �1,41T � � � / �� 7 ��U �J <br />NOTE: WIRING IN NOtJ-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />0 <br />Contract Price of Work <br />Contact Person (Plan Revievil <br />I hereby certily fhal I have read and exurnined this applica(ion and kno�v (he sanie to be frue and <br />coirecL All proo-�sions of la�vs and ordinances goveming fhis h,'ae o! �rork �vill be completed <br />�rhefher spea6ed i�erein or not. The granGng of a pemut does nof presume fo give aufhority fc <br />violate o� cancel the provisions o! any ofher slafe or local l��v re�u/eting consVu�hon or fhe <br />peiformance o/ construction. Thaf 1 om au(hunzed b�� the -��vner ol fhis property fo perfomi the <br />�rork lor which application is mnde and I comply with fhe 5fafe Confructors Law 18.27 ftC W and <br />29G.200 WAC. <br />�'�--_— �� <br />FEE <br />�� s � <br />L�� iL'� - �C'; <br />