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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 <br />73'/S ��lr�; s`csor� �� /i1� �ir�,, i/ z�� <br />PROJEI:T ADDRESS <br />7�r� � / <br />Ownef <br />. 1".�. <br />Tenant <br />Elecirical <br />i�.E'it/ �L'/_ �o�[� <br />State License Number <br />Praposed Use of <br />Mail Aadress <br />Mail Address <br />Mail Adtlress <br />'�/G ? <br />City <br />.�� <br />City <br />f- v <br />City <br />SlalelZip <br />Slale2ip <br />Stale2ip <br />i i � J <br />Phone <br />Phone <br />y,�5 � <br />Phone <br />�/?Qb , 4� <br />Contract Price of Work <br />��'r'y C�JWJS <<1�5� ��7 �/i� <br />Contact Person (Plan Review) <br />Descnplion of Work to Be Done: ��0� P�'� Q�'iIY7 c,CL � r!_S 7L c..F�DYc %.,�. ) d��nf' <br />U�nfi.r� ��C�(.�CC-'i 2C✓/1�v ��e i/t � r(<<-� on A�U�n <br />NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />6 �� <br />, � <br />CITY OF EVERETT LOCAL SALES T.4X CODE IS 3105 <br />I he/eby certdy fhal I havo read and examined fhis applicafion and hno�v the same lo be Bue and <br />conecf. All provrsions ollaws and ordinances goveming fhis typo o/ wo!k will be complefed <br />wbether specdied herem or noL Tho granfing o/ a pemnf does not resume fo give aufhonty to <br />violale orcancel the !�rovisrons o�any others(afe orlocallaw reguPf�ng constn�ction orfhe <br />pedonnance ol constrocfioa Thaf I am aufhonzed by the mvner o/ fhis property to perlomr fhe <br />work /or which applicafion is made and 1 compty with the S(afe Contractors Law 78.27 RCW and <br />296.200 WAC. <br />�_��� <br />��%C <br />