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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� �-, ! ( ", J•� � � �� � �%C (� /� ��'� <br />PROJ�CT ADDRESS <br />1�� �� n; ; /�/ju2,1� ����,�..1�1-- ��.�- `� ��?�_�3 <br />Owner 61ai1 Address City Stale2ip Phone <br />Tenant <br />Mail Address <br />� A!/tl 1'l�:/-�1� l I(7 f_ 1' C.� i C���T <br />Eleclrical Contractor Mail Address <br />n .. <br />�fyi�{�'` `-�"� \1 L �� <br />Slate License Number <br />�� L. S , �,L:.. � �_.� <br />Proposed Use of Building <br />Descriplion o( Work lo Be Done: _!t `^^ V,J ��- � <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 />Cily <br />Stale/Zip <br />Fnone <br />11. l�c :: •LJ U'� �-.J � Z1Li `� Z`i - 4 7� <br />City Slate2ip Phone <br />Contract Price of Work <br />;Jp�� ('wte� �i::: ,��x_�-. <br />_ „ <br />Contact Person (Plan Review) <br />� <br />1 � ;�L �J i � <br />I hereGy certily fhat I have read and exarnined this application and know fhe same to be tn�e and <br />correct. All provisions ollaws and ordinances �overninc� Ihis lype �f work will6e cornpleted <br />whefher specilied herein or not The c��anfing o/ a pernut does not resume fo give aufhonty to <br />violafe or cancel Ihe provisions of any other stafe or local law �eguPating consfrucfion or the <br />perfonnance o/ construction. That I am authonzed by fhe owner oI this property fo peAorm Ihe <br />work Ior which applicafion is made and 1 comply wilh the State Contracrors La�v 18.27 RCW and <br />296.200 WAC. �� <br />, %" �'� \ �-� �— � �1 ' � <br />FEE <br />