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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �. �� !:- t' <br />425-257-8810 - FAX 425-257-3857 — www.everettwa.org � � � <br />Eo9a2-1�7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,'_�i �'-> � • �.�� ', <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Ciry <br />State/Zip <br />Phone <br />� <br />� /� �— <br />�'� � f�l I l)'s ��j � 1-41�� �� �� -11�,L-, <br />Tenant Mail Address City State/Zip Phone <br />-i � �'�: l�n � <br />Electrical Conlraclor <br />Mail Address <br />� �_ <br />�.. .- 's =i `�,�-t �>k �— <br />State License Number <br />�(' C'i . ,� - <br />Proposed Use of Building <br />Description ai Work to Be Done: ' 1>� �'�-S <br />i' �. ���..)'' � �� 1 <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES'fAX CODE IS 3105 <br />Cily <br />�,, <br />nr�� � <br />(� r <br />��\y�(.�117 L: , �) � <br />State/Zip Phone <br />`��. �'l�U _ <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />�� <br />1 hereby certily that I have read and ezamined this applicafion and know fhe same fe be frue and <br />co�rect. All prov�sions olla�vs and ordinancros govermng Ihis type ol work will6e complefed <br />whethar speci�ed herein or noL The grantir,g ol a pemuf does not resume fo give authonty fo <br />violafe or yancel fhe prov�sions oI nny other stafe or local law reguPting cons(ruction or the <br />pe�fo�mante oI consfrucfion. Thaf I am aufhorized by the owner o/ th�s property fo per/omi fhe <br />work lor �j/iich applicafion is made and 1 comply with fhe Stale Confracfors Law 1827 RCW and <br />29&200,WAC. , <br />� <br />� i. -� � � <br />,c <br />, fl <br />� / (� � t <br />FEE <br />F�902- I 1 `�- <br />