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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 42:. -257-8857 — www.everettwa.org <br />aa � � ��'c� L <br />,�_ � ���-c f � <br />PROJECT ADDRESS <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM i���_� ;'� <br />i <br />�jci�1�TF_� ✓3LU1�. <br />� <br />e"c,;, ��,_���,-� <br />-, � <br />�l �� 1� / C KJ �� / G i�i ��l /�-1 <br />Otvnef A1ail Address City Slate/Zip Phone <br />Tenant <br />Mail Address <br />Ci�y <br />s�'�?��'�c�c`lec���« /3r�,�^s /�tv� <br />Electrical Contraclor Mcil Address Ciry <br />�G�ce�i-r2��� ��/DS <br />Stale Licensc Number <br />�I t2 <br />Proposed Use of Building <br />Descriplian of Work to Be Dona <br />c� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />CiE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�� <br />SWte/Zip Phone <br />/ �� s- z �< <br />�- � 1l�i�rj� L�c'� <br />Statc/Zip <br />Contracl Price of Work <br />Conlacl Person (Plan Review) <br />1 hemby ceiiily Ihat 1 have read and examined this application and kno�v the same to be true and <br />conecL A!I provisions ollaws and ordinances governmq Ihis type o/ �vork �vill be cornpleted <br />whether specdied hemin or not. The c�ranting of a pernuf does not p�esume ro c�ive authonty to <br />violafe or cancel fhe provisions o(any ofher state orlocal la�v re�ulalin� construcfion or the <br />perfonnance oI construcfion. That I am aulhorized by fhe owner o! this property fo perfonn the <br />work lor which application is made and 1 comply �aith the Stafe Contractors La�v 18.27 RCIN and <br />296200 WAC. <br />�-- <br />� <br />l''�1// � /O � <br />FEE <br />Phone <br />Ec�oS -D9 7 <br />