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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �/ ` Z�S <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C C���_� �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />J��%� (�c,� �Hlut� /-��t' <br />PROJECT ADDRESS <br />f�i�Gl1 (c�r�Sov� ���� <br />Owner Mail Address <br />Tenanl Mail Address <br />Eleclrical Conlractor h7ail Address <br />Slate License Num6er <br />5�'1C� / �Cfvcloi� <br />Proposed Use of Buildinc� <br />Nt" 6�y ���K R <br />� <br />City <br />Descriplion o( Work lo Be Done: Il �- ��� ou �L (i <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS ftEQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Cily <br />City <br />�l-U <br />�oG_y7q-i7y"7 <br />U uu f I U/� `1d <br />Slate/Zip <br />5lale/Zip <br />State/Zip <br />Phone <br />Phone <br />Phone <br />Coniracl Price ot Work <br />�jriuvt CqrI50N <br />Contacl Person (Plan Review) <br />Gcrr�q�. j � =��� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify tAaf I have read and examined fhis applicafion and know Ihe same fo be true and <br />conect. All provisions o( la�rs and ordinances goveminr� this lype o! work will be complefed <br />�vhefher speciGed hercin or not The granfing o(a permd does not presume to give authonty fo <br />vio!afe or cancel fhe provisions o/ any other sfate o� local la�v regulatinc� construclion or the <br />performance o� construcfion. Thaf I am aufhorized by fhe o�tivier o/ fhis property fo peiform the <br />work lor which application is made and 1 comply �vifh Ihe Sfate Confractors La�v 18.27 RCIN and <br />296.200 N�AC. <br />,- /c /� <br />L�I�c:l.�-� (��L(,�� <br />�/ �— �ii� <br />FEE <br />