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0 <br />ELECTRICAL PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE f, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-2G7-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I�� ���� ���',S�=L�!(.-c, �� /l1%r- �(` l � <br />PROJECT ADDRESS <br />� f�r� �-f\S � �= N i l��' �'/; f S;- �_ << <br />Owner Maii Address City Slale2ip <br />�) 1 ,a� i)� ��' S�� jt 3c�' i_ l)i��c..V��s .�)A`75-CJ�-;. <br />Tenanl <br />Mail Address <br />Cily <br />St:.lelZip <br />Plionc <br />Phone <br />far C_ , <br />l��l'i.=ti (�'/!=< i�lC /j���S /� rl�� �V �� /�l�J %' L�ri � 3"j �'� <br />Eleclrical Conlraclor Mail Address City Slate/Zip Phone <br />�� �� -�c'c• _- <br />C LL-(_Y�/". T %�L�� �7 <br />State License Number <br />Proposed Usc of Building <br />Descriplion o( Work lo �e Done: ( � ' � � `` ' �:' ( � � r- <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 />Conlracl Prico of Work <br />Confact Person (Plan Review) <br />�'- r-11. rLC� �.- _ <br />I her�by certi(y Ihat 1 have read and examined this application and kno�v fhe same to be fruo and <br />correcL All pruvisions o(7a�vs and ordinances govemmg fhis type o/ n�ork will be complefed <br />�vhefher spea(icd herein or not. The granfinr� ol a pernut does not �resume to give aufhonty to <br />violate or cancel U�e provisions ol any ofher state orlocallaw rec�ulafing construcfron orthe <br />perfomiance of construclion. Thaf I am aufhorized, 6y the o�rner of Ihis prope�ty to pedorm the <br />work lor �vhich applicafion is made and 1 cornpl}� �+�dh tho State Contractors La�v 18.27 RCW ond <br />296.200 WAC. <br />�_ . -- , <br />Signalure � _� � <br />C' ;���% �.2� ,i � <br />FEE <br />��2.,='1-�JC� <br />