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EL!cCTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA. 98201 <br />425-257-8810 - FAX 425-257-8857 - www.eve�eltwa.org <br />APPLICATIONS ARL- ACCEPTED FROM 8 AM TO 4 PM <br />� <br />, r <br />�� � ._' (�, �.� /;�;���1?�C�1� �i �� , v i -� <br />�\i�P_� i( i11��Z�rw1 L'�CC.��-Cr`r L(I"�1 �i��l?J�v JZ�I=��/L1�lSC"(��-lL�i <br />PROJECT ADDRESS <br />�7n r,�r c: C ��i v ��--Ti-" �:i l'�' ir(i" lN n- �l 8 7d � <br />O�vner Pdail Address Ciry Slate/Zip Phone <br />Tenanl <br />A4ail Address <br />City <br />State/Zip <br />Phon� <br />4 2j -���• ?3Y <br />l�c•, r n e.. � l � c_.nz-� �, � �� ��l e�� �..�� `i8u%1 <br />Electrical Con�raclor Mail Addr�ss City State2ip Phone <br />f'�A �ZNCCL �.�gj�jP j�3I,{ <br />\� �t- le'-rJ C"�: � d�� c(S � '�.i L.t p O C _ v e� <br />State License Number Contract Price of Work <br />°roposed Use ot Building <br />Descriplion of Work to �e Dona C���, ; i5 1 �u� U� ">t <br />2 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, b1C OR r,C CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contact Person (Plan Review) <br />1 hereby certily fhat 1 have read <3nd exnmined this application and hno�v fhe same to Le frue and <br />conecL All provisions o( /au�s and orAinances govern;ng this fype ol u�o�k u-ili be canple.faA <br />whefher specdied herein or noL The granting o�a pernut does not presume to givr, aufho�ity to <br />violafe or cancel fhe pravisions o(any other sfate or /ocal Ir�v regulaling construc on or the <br />pedorrnance o( consvuction. Thal l am aufhonzed by fhe ov��ier ol this property to perlorm fl�e <br />�vork lor �vhich applicafion is made and 1 comply �aifh the Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />/.� <br />�� <br />� <br />,.. ir/{.� J �?,—�'�— //' . �' C 'r <br />FEE <br />��-12- oz.� <br />