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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 ACCEPTED FROM 8 AM TO 4 PM <br />i / ,'+ /, ? <br />�L!t'c� �' j"q�'l �j' <br />PROJECT ADDRESS <br />� Ji 7 I <br />..r .;'I::1�/ ��� f/7�i % .i-c i C',��^. �/ <br />Owner � � Mail Address <br />Cily <br />-�,�. �i� L{.�� . <br />Slate/Zip <br />=f1�' Z_j 7- 7`//(I <br />Phone , <br />Tenanl Mail Address Cily State2lp Phone <br />�'/�i�.�•r �..I.S �.�5'�i-�'./r.Tja .J�l/E"[.Mi�o����ti fc-y^�%�� �c:''� i�-...r l/1��-�>%-7- <br />Eleclric2l CanlraClor Maii Address City Stale/Zip Phone <br />.��� j�'.�5�v2 ��: <br />State Licenso Number <br />� <br />,�1 t 5 <br />Proposed Use of Building <br />Descriplion of Work to Be Done: <<'1G_�f "r> c" �7 C�+ � y�-, c <br />% l��C�'� <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />t� r/�!, < � �G� /Yt'.� /�. �C� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily thaf i hace iead and examined fhis applicafinn and know fhe same to be true and <br />conec!. All p�ovisions o/laws and ordinances goveminc� this rype ot wak will be completed <br />u�hefherspec�fiedhereir, ornoL The granfin� o/a pernuf does nof presume fo give authonty fo <br />violate or cancel the �rovisions ol any ofher stafe or local lan� regulating consfruction or fhe <br />perfo�mance o/consfruction. Thaf 1 am aufhonzed by the owner o/Ihis property fo perfonn fhe <br />woik !or �vh;ch applicafion is made and 1 comply wifh fhe State Centractors La�v 18.27 RCl4� and <br />29G.200 WAC. <br />_ � .j _C) <br />`;. <br />�O�ll����'i� <br />