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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 7 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org Z� _ I'S —6 <br />APPLICATIONS ARE ACCEPTED FROM 8� TO 4 PM <br />�. � � <br />����i f:/'ic'ii;r�t' L/i S�Gc.' i,C, �I�C�L� L''-'lrt'(% GcJi i i'''�� C.., � <br />PROJECT ADDRESS <br />� <br />/�'/<<f��:.-,-, �i�-,=��/��,s Lr_c". �/ZS-z3z873�' <br />Owner � Mail Addre4s Ciry State2lp Phone <br />Tenant <br />Mail Addwss <br />City <br />State/Zip <br />Phone <br />�.%C�q/� L�t"C F)"'C r;c . ;C�G 7�i/s�/�' ��� i:-�c,� ..5�,�/r L�.`i Sb? 7�. <br />Ele^.lricalContractor MailAddress City � Slale2ip �/�� 8; �;Phone <br />� Y3> <br />C' � �. <br />��?;'i,'Trr,z � /_5 /�� <br />Stale Lic9nse Number <br />�i'!��ci•'[c�� I ��, � <br />Proposed Use of Building <br />`� �c K <br />Conlracl Price of Work <br />Conlact Person (Plan Revie•N) <br />Description of Work �o Do Dona: �� ��K� k ���Y�� � y�"�'0`�-�r� .5-r.�vrc ��' � ��� i�'"r c_-��_ <br />��III f L�� ,� � ' �-, �� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALCS TAX CODE IS 3705 <br />/ hereby cerli/y fhat 1 have rend and examined fhis application and know fhe same to be frue end <br />correcL All provisions ollaivs nnd orJinances govemmg this type ol work will be wmpleted <br />wheUier speafied herein or nof. The c�rantin� oI a pennd does nof presumo to give authonty fo <br />violato orcancel the provisions ol any ofher sfate orlocal lau� rec�u/ating consWcfion orthe <br />perlomi�nce o( consfrucfion. Thof 1 am authonzed 6y the o�rner ol this property fo peAomi the <br />work !or �vhich app/ication is made and 1 comply wifh the State Contracfors Law 18.27 RCW and <br />29G.200 WAC. <br />, � �<"�•� <br />% <br />FEE <br />� � O ' <br />/ I � <br />,� V <br />