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ELECTRICAL PERMIT APPLICATION <br />CiTY dF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />I-v-iS �O> <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/ / / J � <br />/ � � -\ /�--%7' � � `-f / J / ✓/ � ��- <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />% � <br />� i / / <br />i <br />� /�' Q li �'-� l ( <br />Mail Address <br />State license Number <br />Pwposed Use of Building <br />Mail Address <br />M11ail Address <br />� <br />Description of Work to Bo Done: -� '�� �L-E' <br />NOTE: WIRING IN NO^' f'�NELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC. OR AC CABLE. <br />Cily, <br />City <br />Ci�y <br />� � <br />� p rj lL-G <br />StatelZip <br />StatelZip <br />StalelZip <br />Contract Price of Nbrk <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 herebvi certily lhaf 1 have read and examined fhis appficatien and know Ihe sarne fo be true and <br />correcf: All provisions o/la�vs and ordinances govemmg fhis type o(work �vill be complefed <br />whether spealied herein or noL The �ranfin� ol a permd does not resume to give authonty ro <br />violate or cancal the provisions oI any other sfafe or local la�v reguPting censVuction or fhe <br />perlormance o/ const�uction. Thal l am aidhorized by Ihe o�vner o/ fhis property to pe�forn the <br />�vork lor which application is made and 1 comply wifh fhe Sfate Confractors Law 18.27 RCW and <br />296.200 WAC. <br />' i J <br />� � / �; 5 <br />t k��� ' 1�..� . � � <br />�,,...,,,,.,, na�a <br />FEE <br />F c�5 ra-�'�� <br />Phone <br />Phene <br />Phone <br />