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ELECTRICAL PERMIT APPLICATlON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE'f, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wv✓v��.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />�i � � �:, l� 1� ��1-> � <br />;� <br />, . ; ,,; - �.r�f,,�: , { , <br />PROJECT ADDRESS <. <br />-.1,� i� �,,<,<� ( <br />Owner U <br />Tenanl ' <br />/ <br />�l � i� r,�;�., <br />[leclrical Conlraclort <br />Mail Address <br />IAail Address <br />��� �� L U <br />hlail Address <br />,, <br />��� � �- � -.���r: .. <br />J � <br />License Number <br />�; /,t <br />; <br />Proposed Usc o( �uildin� <br />Cdy <br />Cit� <br />City <br />StatelZip <br />Slate/Zip <br />Phone <br />Phone <br />G yU - 7yz - �U�-� <br />State2ip Phone <br />��s,�s� -� <br />Conlracl Price of Work <br />f�i /l .Sa..�✓ �f 7- 7Z(�3 <br />Contacl Person (Plan Review) <br />Descriplion of V�'oik l0 6c Dunu: af1/!•7 ///:� :i�t �)'i �_�•� �.f.Yvi-LC dn-r/ �(.1 fh�ui:G�__—. — <br />/Jvi,Cr� r�,,n-!�t /EPll s/-b✓ir�� �>tir.e[- — <br />, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily th?f 1 have read and exarnined this applicafion nnd kno�v the same to be true and <br />conecL All provis¢ns olla�rs and ordinances c�overnmg fhis f}�pe ol �rork n�ill be complefed <br />whether spea(ied herein ornoL The ��antin� o( a pernut does not resurne lo give authonty to <br />violate o��anocf ihe /�rovisions ol anv other stafe or local la�v re�uPfinn construchon or fhe <br />pedonr�ance of consfrucfion. Thaf 15m au0ionzed by the o�rner o/ fhis property to perlerm Ilie <br />work /or �vNich application is nmdc and I compty nifh fhe State Contractors La�v i8.27 RCW and <br />296200 WAC. , <br />, ; �.:,c:--- �� <br />FEE � <br />J <br />t=��S u> L„l I <br />