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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, FVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�.-� / 1( �-1� <br />�� C � � �3 V �i �l�l I « 1/L- <br />PROJECT ADDRESS <br />�✓�o�' -�• <br />owncr <br />Tenant <br />Eledrical Contractor <br />Stale Licens� Number <br />Proposed Use of f3udding <br />5 5/�Sl� L,�� ll��, <br />Mail Atldress City <br />P,tail Address City <br />A1ail Address <br />Cily <br />Descriplion of Work lo Bc Cune: 7/h� / /y�J /) �`�'� f"�1- <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS RE(]UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />a -a�—o � <br />�07D� -IS�{ <br />; �-i �1"�Zlv <br />StatelZip Phone <br />�v ���� �/� <br />Slate2ip <br />State2ip <br />Conlracl Pricc of Work <br />Contact Person (Plan Review) <br />FEE <br />I hereby r,ertifv thaf 1 have read anAexamined lhis application and Mio�v the same to be hue and L-� � 2_ �Sy <br />coned. All piovisions o/ laws and ordinances govemmg this type o/ work �vill6e completed � <br />whefher specilmd herein or noL The granting o/ a pemut does not resume fo give authonty fo <br />violafe or cancel fhe provisions ol any ofher stafe or local law reguPfir,g cons(ruction or fhe <br />peAormance oI construcfion. Thal 1 arn authorized by fhe owner o/ th�s properiy to perform fhe <br />work !or which applicalion is made and I cornpty with Ihe Stafe Con�racrors Law 18.27 RCW and <br />29fi.?00 WAC. <br />, /�; ., �; � /`_7, /C; .� <br />--- - �;�- - -- — <br />5� ��,� �,�:�,� , � o�;� ' <br />Phone <br />Phone <br />