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� <br />:` <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ` z.Z,�� <br />3200 CEDAR STREET, EVERETT, WA 98201 Z <br />425-257-8810 - FAX425-257-8857—www.everettwa.org ��a6pz.�a, <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />:: � � �� � ���-�/�� ,� �� <br />PROJECT ADDRESS <br />l <br />�, !j- 1- .Z �/ .-C� �'1�,5 C� iL� J�L' i <br />Owncr Mail Address City <br />Tenanl <br />i �C_ � — <br />[ledrical Conlraclor <br />A1ail Address <br />A1ail Address <br />Stale License Number <br />r �� ,� , �� , , � � �� , �,� l ��1�� <br />Proposed Use ol �uildin� � <br />�escriplion o( <br />io a,: o��,�: ,-� <br />i ,i <br />L� <br />1' r�� <br />Ciry <br />� i ��)ti� <br />Slate/Zip <br />State2ip <br />City State/Zip <br />,��� 6�� <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />'l . <br />5 79-� � � �' d U /`��n�1 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />6E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cer7ily thaf I have read and ea�amined ihis applicafion and hno�t� the same fo be true and <br />correcL All provrsions o/ laivs anA wdinances govenun� Uus lype ol work �rill Ge completed <br />whefhcr specilicAhercin or noL The �ranting o! a pernut does not resume lo give aufhonty to <br />violalc or cancel the provisions o! any olher s(afe or local la�v rec�uPting consf�ucfion or fhe <br />perfo�rnance o/conslrucfion. That I am aufhonzed by the ouner o�this property fo periorm tha <br />�vork lor u�hich application is made and 1 cornply wtlh fhe Stafe Contracfors Law 18.27 RCNiand <br />29G.200 WAC. <br />� <br />_. l i,��i �� <br />-���� � .6 <br />FEE <br />.'i U_� � � � ` - <br />J <br />Phone <br />Phone <br />Phone <br />c2- <br />