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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.everettwa.org <br />APPLICATIONS ARE ACCE;�TED FROM 8 AM TO 4 PM <br />� <br />� ��r�/ E,�l.a ,��.. , ,�1�� . �,.��-: �� �vA <br />PROJECT ADDRESS <br />�<i,� L�� f� �� `S� ��L II % �'>,',, /1/J�' `�L <br />Owncr Mail Address City <br />Tenanl <br />[Ieclrir.al Conlr�ctor <br />Slale Licensc Number <br />Proposed Use o( Buildinc� <br />pdail Addiess <br />A1ail Address <br />, <br />Descriplion ol Work lo �e Done: �r'• -��> � t'< <� �' '� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />City <br />Cily <br />�✓r�ai� Gv� <br />Statc/Zip <br />State2ip <br />Slafe;Zip <br />}'s�cj 2�C 3Scc23� <br />Phone <br />Phone <br />Phone <br />Contract Pricc of Work <br />Conl2cl Fcrson (Plan Review� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereb}- certily (hat I have read and examined this applic�tion and know the same to be Vue and <br />corn+cf. All provisions o/ laws and ordinances govaming Ihis type ol �vork �vlll be complefed <br />�vhefher spccdied hm�in or noL The g�aniinc� oI a pam�d does not resume fo give autho�ity to <br />riola(e ur cancM the provisions olany olher sf�te or local law reguPfing construction or fhe <br />perfernuvnce ol construcfion. Thaf 1 am aufhorized by !he o�rner o� this property fo perforrn the <br />�vnik fnr whirh application is nreJe �nd I comply with the S(afe Cont�acfors La�v 18.27 RCW and <br />296.200 WAC. <br />a" o <br />�A � . �,r" <br />/ ,,t ti� ��; 9, rn 7 <br />s�,:�i�,�c � u,�e <br />FEE <br />� �1 <br />