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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CGDAR STREET, EVERETT, WA �8201 �_ a-�-'"�� <br />425-257-8810 - FAX 425-257-8857 - :•,�^,nv.everelhvU.org � O�O� /�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � <br />� <br />. (. i: . � ' %�� .�. % i j_/;. <br />i <br />PROJECT ADDRESS ' <br />� 'i; � ! ��=,, <br />i <br />�WI1Cf <br />' �� ., <br />i=- L� �� ' � � � %� <br />MailAddress <br />i ��'���i <br />C�iy <br />ienanl Nail Address Cily <br />i //`- � <br />StalelZip <br />SlatelZip <br />Phone <br />Phone <br />� p� I <br />q ' i� /�L� / �� � �1��� C � '" . �V �i <br />i <br />� ��/!�/�'�;li�; �: �.', � � /���/lC�t���ji'�u'� /jl/i.�t�'::�.� i �v /.= 0 ii <br />[lectrical Conlractor A1ail Address Gt, Stale/Lp Phone II <br />� �(/'�C �L� � i <� '� <br />�'/i�Li,,;� .h� ���/'�lPr"/i-. -,6�' � �-c� - I <br />Stale License Nurnber Con�recl Price of Work �, <br />�„%.�.;`�'('o�" _ ilirv'!�. �-:sr, . <br />Proposed Use of Building ' <br />%� <br />Description of Work lo Be Done� <br />, <br />� ,�, i� � �.. / <br />(�.� ("f ,�. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� <br />Contac� Person (Plan Review) <br />/' �, r��i/ ✓ .� .,� �--t..' c �G;�'! <br />�`e.f.' � � � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hemhy ceRily fhat 1 have reaAand ea<�mined this applica6on anA kno�r fhe same to be fn�e and <br />corTecf. All provisions ol/aws and ordinances govemmg this type ol wo�k u•i!I be cornpleted <br />�vhether speci6ed herein or noL The gianfing o! a permd does nof presume to give authonty to <br />violale or canr.el fhe provisions o/any olher slafe orlocalla�a !egulaling ronstrucfion or the <br />perrlormance o/ consWcf:on. That 1 am aufhonzed 6y the ownei of ihis property fo perfomi the <br />work �or which application is made anA 1 compty wifh the Sfate Conlracfors Law f 8.27 RCW and <br />2'J6.20C WAC. <br />�� , r � t, e"�. <br />! ,�•r�-�--- ' � � . <br />FEE -� <br />� V@O'L, - �1�- <br />