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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-3���1> ��� Il'l��k���-u�> ����1�1 <br />PROJECT ADDRESS <br />��-, r ����1.,�� �''�� l� <br />Ownef Mail Atleress <br />Cily <br />Stste2ip <br />�! .-3 0 - o�'i <br />Cd�i aG-iab� <br />Phone <br />�C��� <br />Tenant Mail Addmss City StalelZip Phonc <br />- � - - - - �� a��. -�_ v- <br />Eledrica� COntr2clor Mail Address <br />� L� � ����C1 L � c'� �.� C <br />Stale License Number <br />�� V �� �1 � <br />Proposed Use oi B�ilding <br />City <br />Descriplion of Work to Be Done: 1� �V%�{. '�.*l'� ����\ �`�� <br />NC�TE: 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 />S�ate2ip <br />� �.1�' � �l�! <br />ConVad Price of Work <br />`LY11 `� � \ ��7 \ <br />Contacl Person (Plan Review) <br />y certily that 1 have read and ezamined this apUlication and know the same fo be frue and <br />All provisions o/ laws und ordinances goveming this type ol work will be complefed <br />r spec�6ed herein or not The granfing of a pemut does nof presame to grve authonry lo <br />or cancel fhe pmvisions ol any other stafe or local law regulating construcfron or fhe <br />iance of construchon. That 1 am authonzed by the owner ol this property to perlam the <br />�r wlrich application is made and 1 comply wi(h fbe Sfafe Confract�rs Law 18.27 RCW and <br />Phane <br />FEE <br />�Gl� l z� <br />