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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PFRMIT SERVICES <br />3200 CEDAR STkEET, EVERETT, WA 98201 / 0`� 9"�d <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �/0�0 ��� <br />APPLICATIONS ARE .�CCEPTED FRO%'I 8 AM TO 4 PM <br />�L..`� ���nc.�C'r ��-J�� -�� v�-,. ��� <br />PROJECT ADDRESS <br />1 � y / �/.L� •_S�'1_ yj �/ <br />� `r`•�'���e b\ � ''� 11f�1 I � � i � �f�7'� �� i� J°�.�/��+��;, �{,, � /r��L� %���'l <br />Owne� Mail Address Ciry Slale2ip Phone <br />Tenanl <br />� i -- ��i' l-'� <br />:al Contraclor <br />Licenso Number <br />Mail Addross <br />1 ,'ltr�t' <br />M1tail Address <br />��, C c�iti.�t�-� <br />Proposed Uso o( Duildinc� <br />Desciiption of Work lo De Done: <br />City <br />� -��+t ' c �'f.u., +— <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLB. <br />CITY OF EVERETT LOCAL SALES TN( CODE IS 3105 <br />SlaleRip <br />Slate2lp <br />Coniract Price of Work <br />Contacl Person (Plan Roview) <br />1 heieby cmfily fhaf 1 Oave read and exnmined this application ond kno�v the sanie fo de fruo and <br />carocf. All piavisions o( latvs and ordinances governing fhis type o/ u�ork �sill6e completed <br />�rhefhcr spec�Ged Ucrein or noL The �rantinc� of a pernut does nof presume fo gire authority fo <br />viola(e or cancel fhe �rovisiuns ol any o(her stafe or local la�x rec�u/ating cons(rucfion or fho <br />perfrmrance ol con:�nrction. That 1 mn �ufhorized by fhu o�rner ol tlus property to perform fl;o <br />iro�k fer �vhich applicafron is nu�de and I compl}� u�ifh fhe Stafe Contracfors La�v 1Q27 RCW and <br />2?G200 4VAC. <br />_% � � <br />^ �- � . ,;,�'.�_ - -- `?�- <br />�' <br />FEE <br />�_1l>\i� \1C�� <br />Phone <br />Phone <br />