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ELECTRICAL PERMIT APPLICATION <br />CIT�' OF EVERETT PERMIT SERVICES <br />3200 CEDAF; STREET, EVEf2ETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPI_ICATIONS ARE ACCEPTED PROM 8 AM 1'O 4 PM <br />/ �/�5 i-I/+K1�� s:�:..' �� �C <br />PROJECT ADDRESS <br />Owner <br />r��� <br />Tenanl <br />hlail Address <br />J� �s <br />Address <br />Cily <br />,,,,,:,�..�.�, ��� �� <br />Cily, <br />C� R�.rj /v'c `�s 4 C(�� �sv� �, j� si l9 �� j 5.-.:.�<Cc <br />Electrical Conlractor Mail Address Ciry <br />, � <br />ITRc�r i✓e �s-� C" C� �`I�I.Pc+�� �{%a � <br />Slale Licenso Number <br />�1��s/�°i:^ / <br />Proposed Use of �uilding <br />Descripiion af Work te �o Done: -�--7 �`Et l'`' "' � T/. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />I:ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />°'--I�O,� <br />SlaleRip <br />Evc2f>� �✓,� ,�' <br />Stale2ip <br />i,.:� /�'�ivS <br />Stale/Zip <br />.' ��)�)�i <br />Contract Price of Work <br />Phone <br />Phone <br />( .�` oc/,YYj'' y i��, <br />Phone <br />:�%EvE ��L <br />Conlact Person (Plan Review) <br />1 hereby certily fhaf I have mad and examineA Ihis applicalion nnd kno�r the same to be true and <br />conecl. All provisions o/laws and ordinances goveming this fype ol work �vill be complefed <br />whefher speci6ed herein or' not The granfing ol a penrut does not presume to give authonty fo <br />violale or cancel Ihe provisrons of any ofher sfafe or local la�v regu/ating consfn�cfion or fhe <br />pedonnance of consfruction. Thaf 1 am aufhorized by fhe owner o/fhu property to perfomi fhe <br />work Ior which appficafion is made and I cornply �vifh the Stafe Contractors La�v 18.27 RC W and <br />29G200 WAC. <br />� <br />FEE <br />