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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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />y/lo o<.i i.�F� ;�� ���.,r��,�i ,�„� <br />PROJECT ADDRESS � <br />� <br />�,� -�- S�i ��/q,�,-� I �2� <br />�Wnef � A1ail Address <br />fenant <br />(+�v�/ N!�/t� .� <br />=lectrical CoNractor <br />M11ail Address <br />A1ail Address <br />itate License Number <br />l'i•' i �-'.' ;- ���L+� � � c <br />�roposed Use of Building <br />-ari� �,��v� <br />City <br />City <br />Cily <br />)escription ot Work to �e Done: � r.,+ �. ;�: / �,_ /'r; ; ,�,/ c <br />� , ! /' N /' �' <br />JOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />:ITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />State/Zip <br />state/zip <br />Conlract Price of Work <br />7r -j s �� 5-G <br />Phone <br />Phone <br />Phone <br />Contacl Person (Plan Review) <br />iT;c.-�/ ��r�,l. C�;"iF/Sd- <br />I herebvi certi!}� thal I have iead and exarnined this application and know the same fo be true and <br />correcL All provisions ollaws anAordinances governutg fhis type oI work wil! be complefed <br />whefher sp cdied hercin or noL The �ranfing o/ a pernuf docs nof �resurne fo give aufhonty to <br />violate or cancel fhe I�rovisions ol any ofher sfate or local law regulafing construcfion or the <br />periomiance o/ constiuction. Thaf I am authorized by Ihe owner o( this properiy to perlorrn the <br />work lor �vhich application is rnade and 1 comply wifh the Sfale Conhacfors Law 78.27 RCW and <br />296.200 Ih�AC. <br />�_-� i r �� � � c -; <br />FEE <br />� 0"1 1 I - U"3$ <br />