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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 ACCEPTED FROM R AM TO 4 PM <br />,_ `{ j� '�,� j i? �_, r I�11�{ �./,�. <br />PROJECT ADDRESS <br />�U� �1� C, �,� <br />Owner <br />r-ti �— <br />Tenant <br />A1ail Address <br />Mail AtlOress <br />�_af.���C`iuji@ <br />Eleclrical Contraclor ` 61ai1 Address <br />_�'li������C- �`'iZf� <br />Slata License Number <br />�li � <br />Proposed Use o( Duilding <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABIE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Ciry <br />City <br />S[ale/Zip <br />State2ip <br />'�^/t 9b'ov�f s zmE � <br />Slale/Zip <br />� � oc�. t� <br />Conlract Pnce of Work <br />Contacl Person (Plen Review) <br />�U�_.Y�/v/�y '� '')t�dJ%�i <br />I herebp ceAily fhaf I have re:vd and exammed this applicalion and know fhe same fo be true and <br />conect. Al1 pro�nsions ollaws and ordinances gaverning Ihis type ol work will be comple(ed <br />�vhefher speciGed herein or noL The �ranfing ol a pennd does not presume fo give authority to <br />viofate or cancel fhe provisions ol any olher stale or local la�ti• regulating construclion or the <br />perfonnance o/ construction. Thaf 1 am aulhorized by the o�vne� ol this property to perform fhe <br />work lor wh�ch application is made and I compty wifh the Sfafe Con(ractors La�v 78.27 RCW and <br />29G.200 WAC. <br />I / �' T <br />����%'%� �i� �ii�2?' <br />FEE <br />�G-7/G—ll� <br />PhOne <br />Phone <br />q-� �, <br />Phone <br />