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ELECTRICAL PERMIT APPLICATION <br />, <br />� � �_<-- <br />PROJECT ADDRESS <br />.�� � S�a___, <br />Otvner <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEFETT, VJA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i.��-��� i <br />;� - <br />���, �4 <br />Atai� Addmss <br />�tail Address <br />,, . <br />ci_, r .,�-f -� <br />a�y <br />City <br />,. <br />`�; r> 1<�-�� / <br />StateiZ�p <br />State/Zip <br />� -ab -o� <br />� o9�z-�Z3 <br />Phonc <br />Phone <br />���_c- ��;:/-?i .' i'-i <br />; N j � f�-�- !,� �> �, 3' i�,1a�� `> � z <br />rc, r� n � S k'�-�C i�.� 1� ,�s � <br />Eledrical Conlraclor hlail Address Ciry StatelZip Phone <br />TNTCU--:t,v'�1�1.. � — � O � S�^ <br />Slate License Number ��q Conlract Price ol Work <br />V/ <br />'` S7z.�, <br />' i,�_l�i' ,: i� �c�- �i�- <br />�,�,.c, r�ra�l.L <br />Proposcd Use of Building Contact Person (Plan Review) <br />Dr,scriplion o( Work to 6e Done: i���' �� <br />, <br />. �1.� lt <br />} � -�i�t �ti ccr, ��r �,sc✓ S�yi ��s �% F� '�����`� <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 />1 hereby ceriily (hat I have read and examined Ihis applicafion and kno�v fhe same. fo 6e hue and <br />correcf. All provisions o/la�vs and ordinances governuig fhis type of �roik tvill be completed <br />�vhether speci6ed herein or roc The granting o/ a pernut does not preswne to give aufhonty fo <br />violatc or cancel the prrnisions ol any other state or local la�v rec�ulating consVuchon or the <br />peilorrnance ol construction. That I am aufho�ized by the o�t�ner o/this property fo per'lorm fhe <br />worA Ior which applicafion is n(ade'nnd I compty u�ifh the State Contraclors La�v 78.27 RCW and <br />296.200 WAC. l <br />_.7 �. � �' .- <br />l � �>. <br />�`f,�/���/�� C% � � ��� ��.�. � �� / <br />�! ��/ / � -- Dnte � — <br />� Signature <br />FEE <br />�c�c�— ��3 <br />