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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEUAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-.:57-8857 — wv�nv.evereltwa.org <br />; ,t;`1 <br />� <br />PROJECT ADDRESS <br />Owner <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 1 S►= <br />.-����: <br />A4ail Aadress <br />Tenanl Mail Address <br />��� C�� F l�� \� � «� � �.� <br />Eleclricai Contraclor Mail Address <br />Cu��cc� <br />Slale License Number <br />Proposed Use of Building <br />�escription of Work to Ge Done: _�� <br />i�- C�le <br />City <br />Cily <br />�ce5 5}�3 <br />Cily <br />7a�i( K�:.� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEVJAYS, MC OR AC CABLE. <br />v� <br />Stale2ip <br />State/Zip <br />l� St Sr <br />SIaIe/Zip <br />Phone <br />Phonc <br />�z5 ,'�j C, <br />3�Y- <br />Phone <br />�5�� — <br />Contract Prico o( Work <br />Conlacl Person (Plan Review) <br />�S � f2Z P �afE� �on`ae ��ci�� <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />1 hereby ceriify thaf 1 have read and examined Ihis applicafion and knotv fhe same to be true and <br />conncL All provisions o/ laws and ordinances govemmg this f}�pe o/ work �rill be completed <br />whefher speci6ed heri in or noL The �rantinc� o! a pemuf does nol uesume fo �ive authonry fo <br />vio(ate or aancel the provisions o(any orher state or locallarv r�gul3ting con^(ruc6on or the <br />perfomiance o/ construclicn. Thaf I am aufhoiized by the mrner of this property fo peiform �he <br />work lor wlricH epplicelion is rnede end 1 ro��rply with ( ie Slole Caihaclors Le�v 18.27 RGW and <br />29620D WAG ,.-�.? <br />,. �. <br />�; <br />/. �; � ��- �/� r /I � <br />— - �„� <br />FEE <br />'.� !-� (,\1 <br />_ lJ <br />�1�'���-G��-� <br />