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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 />I � � �• � <br />PROJECT ADDRESS <br />� n <br />� �l c �C. 1 J(' �. � <br />Owner <br />Tenant <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��r,1 I�fiN�� <br />� <br />��� �J _� . . <br />Mail Addross <br />Ma;l Addross <br />Clly <br />City <br />Stale2ip <br />Stale/Zip <br />Phone <br />Phono <br />S�.�r,��Cr'�\� CI,Cc�'�\(, �'li>> �-Ci151' Si IU�J s?f�Nw�»� 1.��� ��25 J��u J�`�`j <br />Eleclrical Conlractor � Mail AdCress Ciy Sta1e/Zip Phone <br />;��rr,r11 lLl ��Oc� K—L <br />Slato Licenso Number <br />��F. <br />Proposed Use of Building <br />(,n_��� <br />Conlract Prico of Work <br />Conlact Person (Plan Reviow) <br />,, n !, n <br />Descriplion of Work lo Dc Done: w� Y-�- rJ�=� �� ��, �.L'0 (��Y`1' SC V�� � <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 cerii(y thaf I have read and exarnined fhis applicafion c+nd know the same fo be fruo and <br />corr�ct. A/l provisions olla�vs and ordinances govertiing this typo o/work �vdl be complefed <br />�rhether speci(ied herein ornoL The �rantinr� o(a portnd does nof presume to give aufhonry to <br />violate or cancel the provisions ol any other sfafe orlocal law regulating construction or Ihe <br />perfortnanc:e o/construction. That I arn nuthoiized by fhe owner o/ fhis property to peifomi the <br />work lor which applicalion is made and 1 comply �vith fhe State Confractors Laiv 18.27 RCW and <br />zss.zoo �v,ac. <br />_�_— <br />\���._ J- � �i� • <br />FEE <br />