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I� � ��, �T <br />� <br />� �-C`�� <br />[O��i�-l� 1 <br />,-. <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 —www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,��U � �;I�Cirlc� �UE' C.vt'�'�t-� l/�Jy�{ �i��j'�-�G � <br />PROJECT ADDRESS <br />�-1,-��,�� L� <br />Owner <br />Mail Addrass <br />CRy <br />� <br />StatelZip <br />Tenant Maill.ddress City StatelZip Phone <br />C3��) ��u-��ss <br />�I�'��t� iiS��ItiJ�� �C�,� �=��l��d � �� i � lY1 �r1rc�-f' w;�� � �-t �'.�-� a <br />ElectncalContractor MailAddress Ciy StafelZip Phone <br />Slale License Nuinber <br />��U, <br />, v�i«��r-,}�c��� ���(('<<<� <br />ProposeA Use ot Building <br />Descriplion o( Work lo Be Done: <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 �5 3105 <br />� _ _. <br />.� <br />ConVad Pnce of Work <br />"t�� n �; � 4t,Y ki�5 <br />Contad Person (Plan Review) <br />I here6y certily thaf I have read and examined fhis applicati�n and know Ihe same fo bo frue and <br />correcf. All pmvisions ol laws and orclinances goveming fh�s fype of work will be oomplefed <br />whether specAied lrerein or not The grenling ol a permd does not presume lo give authonty fo <br />violale or cancel the provisions o! any olher slale or local law regolafing consfruclion or Ihe <br />perfoimance of consfruclion. Thal 1 am authorized by fhe owner o! Ihis prvperty fo peAam fhe <br />work !nr which applicafion is made and 1 comply wifh !he Sfafe Contraclors Law 18.27 RCW and <br />296.200 WAC. <br />�--- � 2� 1�� � Z D c� � <br />FEE <br />,� 3< <� <br />� J <br />�0`�IZ � 1 Z`1 <br />O <br />�'( ��� , �) C� �� S �� --� US�/v <br />