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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRFET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM IC- �. ]�� Oc� <br />� C� ��,'lC' -l_��i <br />lfnr, ,-��.r�7 Di� E✓��,ii �JE+ <br />PROJECT ADDRESS <br />1 �a,,�� r;:, ii��nvs � <br />Owner A7ailAddress City Slate2ip Phone <br />Tenanl Mail Addross Cily State2ip Phone <br />'f�7 <br />(; r.-,� , � � � e Cz c=rz��,c f'o ?_ Y�U �zC-n r.�,� 9�t l3 � 5 �-l-I� <br />Eleclrical Contrac�or Mail Address Gty Stale2ip Phone <br />�:-.��«. �� z7?_ �1Gc= <br />Slale Lkense Number <br />Proposed Use of Building <br />[�—�+G�� �UC� "�: <br />CoMract Price of Work <br />Contact Person (Plan Review) <br />DescriptionofWorhlo[3eDone: /��IC(jiC�� ��1.+r9�F ��L✓/G�" � !—e�y�L <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 3705 <br />I hereby certily that 1 have read nnd eaarnined this application and kno�r the same lo be true and <br />correct. All provisions olla�vs and ortiinances govemmg fhis t}�pe o/ irorir will be complefed <br />whether specd�eA herein ornoL Thu granting o/ a pennrt does nof �resume fo give a�dhonty fo <br />violafe or cancel the I�rovisions ol ar;y ofher sfate or locnl lair reguleting consfn�cfron or the <br />pe�fortnance o/consfnicfion. Thaf I am aufhonzed by fhe owner ollhis properiy to perlonn the <br />work lor rvhich applicafion is made and 1 comply wifl� fhe Sfafe Contrnctors Law 18.27 RClNand <br />29G.200 WAC. , <br />" ;', �;/ %,i " <br />/�/,; � /D <br />FEE <br />Cvaio �Iz`l <br />