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�i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEP7ED FROM 8 AM TQ 4 PM <br />i �� W <br />' i ' l ��i �✓L <br />PROJECT ADDRESS <br />���cc�:�c� <br />Owncr <br />/-�/-1�E5 <br />��SFlIIaG�It� <br />�D <br />G�� �Y� c�� <br />City <br />S ;�v"v�s <br />St2tc/Zip <br />'�Z s � x� 7 <br />� <br />Phone <br />(..l`�,C�[: G�r'i? _— �TL1�MeS 1, r c - <br />Tenant Mail Address City State/Zip Phone <br />Eleclrical Contraclor hlail Addmss <br />Slate License Number <br />S F��- <br />Proposed Use of Duildi�g <br />Descriplion of Work to Du Dane: �Cr� � �( W� <br />NOTE: WIRIN6 IN NON-DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ci�y <br />State/Zip <br />Contract Price ol VJork <br />Contacl Person (Plan Revie�.v) <br />! hereby certity fhat I ha��e read and ezamined fhis applicafion and know fhe same fo be true and <br />correct. All provisions o( la�es and ordinances goveming fhis t}�pe o( work will be contp;eled <br />whelher speciGed herein or noL The �ranfing o! a pernut does not presume lo give au(hority lo <br />violafe or cancd fhe provisions ol any olher state or local Imv regulafing construcfion or the <br />perfonnmice o/ construcfion. Thaf 1 am authorized Gy (he owner ol fhis property fo perform the <br />work ler which applicafion is rnade and 1 comply wifh the Sfate Contractors Lau� 78.27 RCW and <br />296.200 WAC. <br />� V � <br />,, , <br />� ;� <br />_��. � �' r <� �, � �u�, . <br />FEE <br />� <br />Phonc <br />L osa9-�l <br />