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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CED,4R STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APP�_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�G' r`�'� �� t'�ei;/,���`''�. <br />PROJECT ADDRESS o <br />�/-(" j1i/ c�`'"j��:'i C <br />, . / -" . :}: -� ' iii <br />Owner <br />, <br />i�' <br />Mail Addmss <br />�%�'k .�� �it•..�,- <br />Tenanl Mail Addies��, <br />'ij'�;�" �j�� ��!/7':Y_� Ct:.i�i. <br />� <br />Electrical Conlraclor Mail Address <br />Slate License Numbcr <br />Proposed Use of Building <br />� <br />�i�Y ' <br />City. <br />Ciry <br />Ci�y <br />/ /L�"/ . <br />Slzte/Zip <br />SlatelZip <br />State/Zip <br />Contracl Price oi Work <br />., � <br />�' '>-�' �>�' <br />i <br />Phone <br />Phone <br />Phone <br />Conlacl Person (Plan Review) <br />�'���.c':;c%7 �%Y-1`.�:;.; ° ;�r,�� �',/n ,�s,�,.�;:�. <br />Descriplion o( Work lo Be Done: ��.- <br />NOTE: W IRING IN NON-DW 6LLINGS IS RE(�UIRL=D TO <br />BE IN RACEWAYS, A1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby ceriily fh�f 1 have read and exarni�ied fhis application and knou' the same fo be true and <br />correct All pruwsions ollaws and ordinances governmg this t}�pe ol work will be completed <br />�vhefher speci6ed herein ornoL The ��anfin� of a pernut does nof resume to give authonty fo <br />violate or cancel fhe provisions o( any other slate or lucal la�v �eguPfing consfruchon or the <br />per(ormance o/ construcfion. Thaf 1 am authorized by the owner o! this property to peAemi the <br />�vork (or which application is made and I compty wifh fhe Sfate Contracfors La�v 18.27 RCW and <br />296.200 WAC. / ., <br />- �ia� •.-�iL � /' =-✓-�.__� � // �i/!.� .,>Z�"— <br />, Sic�nawrc � j/ Date � <br />FEE <br />� �+� ��: �� � <br />