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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425 �57-8857 — www.everettwa.org <br />/2-/S-0S <br />C- oS 2 _ �dz'i <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPI'ED <br />►�-"'�'—i.� .� �/�/ f �7�'cr. f f � S-- <br />PROJECT ADDRESS <br />�\//''y > <br />'I� CiI.� --,.�J J�r: f�/'.•.�+i< % ,> `"7// Z /7�i�J" L.iC-�vr%� (T//t �% (i�:� u � �.).}"-�!J'C <br />Owner Mail Address Ciry State/Zip Phone <br />Tenant <br />Mail ti�Aress <br />Ciry <br />Stale/Zip <br />Phone <br />' i�.;N�� �L• ^. � !'�c; �r��. �'c�ii � �'7 /�i / -�-, /.'._. <br />r <br />E�ectrical Contraclor Mail Address City Slate2ip Phone <br />Slale License Number <br />r'�"f-7�C l S . � -< <br />Proposed Use of Building <br />%OG "' <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />Descriplion of Work lo Be Done: i -�, f /' � > `� i �r � � � %• �i/ �-• � <br />. <br />� <br />'���.L���' r` <' �<�c ; r. ti- _ .. � .c' .ri� _ <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 />l here6y certily fhat I have read and examined tliis application and know the same to be frue and <br />correcL All provisions o/ laws and ordinances goveming this type o/ work will be complefed <br />whetlier specdied he�ein or noL The granting o/ a permit does not presume to give authonty to <br />viola(e or cancel the provisiens o(any other stafe or locallaw regulating construction or the <br />performance o/ construction. Thaf I am authonzed by fhe owner ol th�s property fo peAorm the <br />wak /or �vhich applicafiai is made and 1 compty with the State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />'� - � �� -li J <br />FEE <br />�J S�?. 1 v <br />( �7 <br />� �� � r <br />