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ELECTRICAL PERMIT APPLICA.TION <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 ACCEPTED FROM 8 AM TO 4 PM <br />'� lC; C� � /� `t,� S `f" <br />PROJECT ADDRESS <br />�� L �e Y � 5e� <br />Owner � <br />1�,1.�a' <br />Tenant <br />Eleclrical <br />Sl2le License Nuinber <br />Mail Address <br />Mail Address <br />hlail Address <br />( _i � / i. .y_-C �.� �77�� 7",ctc c_ <br />Proposed Use oY6uilding � <br />Descriplion of Work lo �e Done: � ��/ i`� <br />NOTE: WIRING IN NON-D1'V[ILiNGS IS REQUIRED TO <br />DE IN RACEVlAYS, MC OR F�C CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�.� �1�_ � � �c �e._ <br />City <br />Gty <br />Cily <br />/ <br />lL�;-' fi�1C5 zs�5�7,� <br />Slate/Zip <br />StalelZip <br />Slale!Zip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby coiii(}� fhaf 1 have read and examined this application and kno�v fhe same to be Vue and <br />correcL All provisions ollaws and ordinances goveming fl'is type o( work �rill be cornpleted <br />ishefhr-r specibeAherein or noL The granting o! a pernuf noes nol resume to give authonty to <br />violafe or cancel the provisior,s o! any olhe� sfate or local la�r reguPfing consfrucfion or fhe <br />performance ol construction. Thaf ! am autho�izeAby the o�sner ol fhis property fo peAomi fhe <br />work lor nhich applicalion is made and I comply wifh fhe Slale Con6actors Law 7827 RCW � nd <br />296.200 WAC. <br />, � :7_ — <br />— � �� �< < 1�, � <br />%/�:�� �� <br />FEE <br />Phone <br />Phone <br />Phonc <br />� U�DO��-C�70 <br />