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ELECTRICAL PERMIT APPLICATION <br />> � � �7 S <br />PROJECT ADDRESS <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />z N'� /i UI= 1=�%��-!-� I <br />�;: � yuq-�3y� <br />���U1�1 i rlN� ��.S;:tJ S I�N1� � <br />Owner A1ail Address City Stale/Zip Phone <br />Tenant <br />A1ail Address <br />Cily <br />Slale/Zip Phono <br />--� <br />' ?�( ` � L`> I N � �� �= �-�--�, i !ZI �. �` � I N C <br />Electrical Conlraclor �� Mail Address Ciry S1ale/Zip Phone <br />r��v��r-c.00s�N� <br />State License Number <br />S t-f= <br />Proposed Use of Buildinc� <br />Conlract Prico o( Work <br />Conlacl Person (Plan Review) <br />Descriptioa of Work to Be Done: �� r I�UK.L' L' J( S( j � I Iy V I 0 e /� M 1° S ti i� V l� r <br />r,ur i r-i �.,1P—tu) • �c /t�l�i �' � CRV�L1= <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 />1 hereby certi(y fhat 1 have read nnAexnmined fhis application and kno�v the sarne fo be 6ue and <br />correct. All prov�sions o(laws and or'dinances govemm� this fype o/ work �rill be completed <br />�rheUier speci6ed herein or noL The �ranting o( a pernut does not presume to give aufhonty to <br />t�iolate orcancel fhe provisions ol an}� other sfate or Iecallaw regulafing wnsWcfion orihe <br />perforrnance o(construcfion. That 1 arn autliorized by the owner o(Ons property fo perlonn �he <br />�vork lor ivhich applicafion is made and 1 compty �rifh Ihe Sfafe Contrt�ctors La�v 18.27 RCW and <br />296.200 WAC. <br />,i <br />FEE <br />�� ���1- i 12 <br />