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�� 6 I <br />PROJECTADDRESS <br />Owner <br />Tenanl <br />{ <br />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 />"� . �"l��i �lir <br />oq-c.L(Lt � <br />Mail Addross <br />Mail Address <br />� <br />City <br />City <br />lu�<r-n-r�C.YJAL �ZGrC'i�l�c_ N%Q'�i�1�� <br />[lectrical Conlra or htail Address City <br />L�E���3��1� �� <br />Stale License Number <br />Proposed Use of Building <br />Description of Work �o Be Dono: <br />� <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 />I hereby certify fhaf I have rend ond exnmined this applicalion and k�wu• the <br />correct. All provisions ollaws and or�iinances govemrng fhis ty pe ol work w, <br />whether spealied hemin or noL The c�ranfin� o/ a penmt does nof ��esume <br />violafe or cancel fho pr srons o( an}� ofher sfate oclecal le�a rac�u�afing con <br />per(ermance ol constru f n. That ! am aufhonzed by the o�rner ol lhis prop <br />work lor which applicafi n's mede.and !"comply with the Stafe Confractors L <br />296.200 WAC. - 1 , - <br />� <br />� � � �li � 1 � o <br />_ _� -t��+y ���5 <br />-- Lrx��t�ts' �o�c/,S � , G'v <br /><.C/i�/l1 � i h._ .,/� r..o r vciJ <br />� ��� <br />Slate/Zip <br />Stale/Zip <br />Stale2ip <br />�� �> <br />Contracl Price of WorY, <br />Contacl Person (Plan Review) <br />� <br />ie fo be true nnd <br />complefed <br />'ve authonty fo <br />•tion or fhc <br />fo pe�fomi the <br />18.27 RCW and <br />�Z�� <br />Phone <br />Phone <br />=3 � � <br />Phone <br />FEE <br />(�l �— v�� <br />�(�.-� 3�� �/- S3 s 3 <br />6c���.-� P��2��Sr��,� � <br />- (�'(a2v�._/ /�/r r..i � -o /� <br />(c�C���1'�0�..�� %'�� cMl < <br />