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ELECTRICAL PERMIT APPLICATOON <br />CI'fY OF EVERETT PERMIT SERVECES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APF'LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I <br />� � � � ��� .��,� , ,, � <br />PROJECT ADDRESS � <br />f� J � <br />oW�,�� <br />Mail Address <br />c�iY <br />Stale/Zip <br />� - a 8- v� <br />C pgo5-isz <br />Phonc <br />TenaN Mall Address City State/Zip Phone <br />� <br />�L�� J�� <br />�'r,r��„rn i CLG�-�� i��� G, �1�s 2��� -,r5i-n�4,1 S�ANt.a�D ��1 i5�=i2 57`�`� <br />Electrical CoNreCIOr Mail AdAress Ciry Slale/Zip Phone <br />f �� Pr� ��. ( OcY� <br />S�ale License Number <br />D'���L=x /G-h��-/'•.`,sL: <br />Propased Us� o( Buildin� <br />Con�ract Pricc o( Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: (i� i r�+;. �j _) �L�. X -�J-�,1_ fa (.1'�� j U ��� /� fV'��' S[��v�LL <br />NOTE: WIRING IN NON-DWELLIPJGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Cli'Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I herebvi certily 7haf I have read anA exammed fhis applicafion and know Oie smne to be tn�e and <br />conccf. All provisions o/laws and ordinances �overnmg fhis type olwork will be complefed <br />whelher specilied herein or noL 7he �ranfin� o/ a pennd does not presume fo give aufhority fo <br />vio!ate or cancel fhe provisions oI any other sfafe or local law re�ulatin� construction or the <br />per/om�ance o(consfruc(ion. Thaf 1 am aulhorized by the owner �/ tins property to periorm the <br />work !or which applicafion is rnade and 1 comply �vifh Ihe State Coni �aclors La�v 78.27 RCW and <br />296200 WAC. <br />FEE <br />'Z.�d �1 � J� / � �— <br />