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( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PEi2MIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 E,M TO 4 PM <br />1`��C� l.� j�'�.,\-.�V�=',�- -���'�I!y <br />PRUJECT ADDRESS <br />� <br />��)!J'C� �- - ��i� � l �:� �'}�_� �. �'1� �„��y-���1 <br />Owner � Mail Address <br />TCnaN Mail Address <br />� <br />�,"�".c'�a�v���l �������-�L- �.�; T�� <br />Eleclrical Contraclor htall Address <br />�,�,�{� ,�1 ! I`� � ��_ %''<<;�'-' �) .�') <br />State Lice�se Number <br />Proposed Use al8uilding <br />Description of Work l0 6c Dono: � i�J \�C � �\ ��� <br />NOTE: W IRING IN NON-DINELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODF �S 3105 <br />Cily <br />Cily <br />City <br />, , r. <br />L� l. ��� � . . - � � � �� �� <br />Stale/Zip Phone <br />Slale/Zip Phone <br />LV'ci� 1.^���i ( ��C�� <br />Stale/Zip Phone <br />Contr2ct Price of Work <br />Conlacl Person (Plan Review) <br />L VL� � � �� � � �A�� <br />1 heroby certify fh��f 1 hare read nnd exarnined this applica(ion and know fhe same fo bo Uue end <br />correct. All provisrons ollaws and orciinancos goveming fhis type ol �roric wi/l be complefed <br />whefher spea6ed herein or noL The c�ranfing n1 a permd Joes r�of resumo fo give aufhonty fo <br />violate or cancel the provisions oI �vq� ofher sfate or local f�3�v reguPting construcfion or fhe <br />perfomiance oI const�vcfion. Thnt 1 am nufhorized by fhe o�rnero/ fh�s property to perfonri fhe <br />�rork lor which applicafion is mnde and 1 compty �rith fhe Sfafe Controctors Law 18.27 RC W end <br />29G.200 l�'AC. <br />� <br />c^ _� I I I;�: <br />FEE <br />� <br />