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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 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�`�S � � \� � 51� S��Q.�,-� <br />PROJECT ADDRESS <br />;�rr��. \��1c�va,vuZ h5'iZ N��i�1 . tv.z,�.�k W A ���u� �Uzri s�`i' �� 3� <br />Owner Mail Address Clty Stale2lp Phone <br />Tenant <br />Mail Address <br />��c.�,r�C <br />Eleclrical ConUaclor � Mail Address <br />\��C h31v F �- �'�'� �:� <br />Stale License Number <br />Proposed Use of Building <br />City Slate/Zip <br />City <br />1,\2 h� i>� �— l_ <br />SWte2ip <br />Contract Price of Work <br />Phone <br />��� � <br />Phone <br />Conlact Person (Plan Review) <br />� �- ��9_( �' �. U.�',�s� �-�.Q.L�,%-P � <br />Description o( Work to Be Done: �`n�� C� � � � <br />cv�I�c� c ��i v � �� ��n �,���>`�'C�v`�S �(CiC��n'� <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 />I hereby ce�fily fhal 1 havo reod and exnmined (his opplication ard know fl�e same to be true and <br />correct. All provisions o(/aws and ordinances goveming tliis typ3 of work will be completed <br />whefhe� specified herein or noL Tho c�ranting o1 a pemuf does r;ot presume fo give aufhonfy to <br />violafeorcancelthe provisionso(anyothersfateor/ocnllawragWatingconstructionorthe <br />performance o( constructlon. Thut 1 am authonzed by fhe o�vuer of fhis property to pedomi the <br />work for which applicafion is made and 1 compty with fhe State Con(rec(ors Law 18.27 RCW and <br />296.200 WAC. <br />� � ,,,,,k LC. � �-��-��-'�- _ � � -11 '_�,' <br />FEE <br />� <br />