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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.evereltwa.oru <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S_� 6� iJ, <br />� f'-t�5 ,-IAti�>>Cs�.,ti� �c,�o �<<i��= <br />�Y�2�- �:.c�, <br />PROJECT ADDRESS <br />Owner <br />A1ail Address <br />Ciry <br />�D �,� r��.-13 <br />StalelZip <br />Phone <br />i � <br />- �-YJ%��-`�$� IJU/�Ii�l .5�1`Ui� -�1-��S ��-L�:�QP.i�7J �LYt �iit�c'�� <br />Tenanl Mail Address City StatelZip Phone <br />1�1��yf�l.=�Y L�L��C�(i'—Ac LL-L �S (1 l,�iUr-)f'� C`(�Llf llwq- �'�'�2t+� <br />Eleclrical Conlraclor M11aii Address City Sta�e2ip Phone <br />�l3 A«n� r C- �- �l i C� '-I3 � <br />Slale License Number <br />� ����� ; S �l � � �., <br />Proposed Use o( auilding <br />Descriplion ol Work �o Be Done: <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES " AX CODE IS 3105 <br />' JD��= <br />Contr- P ice of Work <br />ContactPerson (Plan Review) <br />I hereby certily that I have read and examined Ihis application and know the same to Ge true and <br />correcL All provisions o/laws and ordinances govemmg flus type o/ �vork will be completed <br />whether spec�lied herein or noL The granfing o� a perrtut does nof �esume fo give autbonty (o <br />violate or cancel the provisions ol any ofher sfate or local larv reguPfing consfrucfion or the <br />performance o(construchon. That 1 am aufhonzed by Ihe owner o/ fhis property fo pedonn fhe <br />work lor which application is made and 1 comply �ti�ith Ihe Sfate Confractois Law 78.27 RCW and <br />29G.200 WAC. <br />FEE <br />; (aJ �'/J� <br />