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�LECTRICAL 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 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />n �, -� �- �� � <br />L,3"LiL �t�C!//,-r✓�'-� �_$ �/,.�. <br />PROJECT ADDRESS <br />�J �._ 7� c � <br />� <br />.? <br />/� ���" C�c ;,./,, •.- - � T�-�<- � r ':i/� i� /.E'.... 1f' .�� -' r;�P,-,o il C�/i( ��, <br />��� � <br />Owner Mail Address City State/Zip � Phone <br />�i.�i.? <br />Tenant � <br />_� �1L'.0 (,�P %vs.d�C l—✓[ <br />Mail Address City <br />State/Zip <br />Phone <br />t <br />/? �.=Y.s:r ,.•.-.� � r/r-: /:: � .f � ✓-'��,^� -� �i `/ /��: ,/e �✓r; j !'�i � 3 <br />Electrical Contraclor Mail Address City StatelZip Ftione <br />State License Number — <br />Preposed Use of Building <br />� � ci <br />Contract Pnce of Work <br />Contact Person (Plan Review) <br />^ , <br />Description of Work to Be Done: /7; i,�' f.. f 1- i� -„ i-�r' � �• � y� r��.� } <br />s <br />fF/�G� �, � .j <br />NOTE: WIRING ItJ NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certity that 1 have iead and examined this application and know the same :o be true and <br />cor�ec7. All provisions ollaws and ordinances go�ermng this type o( work will be complefed <br />whether specihed herein or not. The granting ol a permd does not presume ro give aufhority to <br />v�olate or cancel the provisions olany other stafe orlocal �aw regu/ating construc;ion or fhe <br />Wc�k%rawh ch appl crat Cn�s mahde and I cotmplyev (h 1he Stafe Cont z�ctorsPLawy18.27 RCW and <br />296.200 WAC. <br />■_ <br />/%� J'c. t�� — <br />FEE <br />S�f v <br />si z c�oz <br />