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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4?5-257-8810 - FAX425-257-8857—www.everettwa.org <br />AP�LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />.���'x� 1.11 C-i iY10�?� I�IVI. . �:�����L - <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Eiectrical Contractor <br />, ��' � <br />Stat� Licerlse Number <br />Proposed Use of Building <br />Mail Adtlress <br />Mail <br />Mail Aadress <br />City <br />iec� G'� <br />c��y_ <br />Ciry <br />State/Zip <br />State/Zip <br />State/Zip <br />�-K/'/ <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Fhone <br />Phor.e <br />� • <br />Description of Work to Be Done: 1��+� ����� 1�\ i lcb �� l•;1".LL ) U' r1) ��; x IS�T ��', <: ��( C t� � 1�� i' <br />� r� ^r <br />�— <br />�'��t��.0 `r, �.�c. `�C� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />6E IN RACEWAYS. MC OR AC CABLE. .-� <br />-: % <br />CITY OF EVER�TT LOCAL SALES TJJC CODE IS 3105 <br />I hereb}� certily that I have read and examined fhis applicafion and kncw the same to be true and <br />csrrecL AI! provis+ons o( laws and ordinances governmg this fype ol •�vcrk �vdl be completed <br />�.�hefher speu6ed herein or neL 7he granting o/ a permd does ncf resume to give authonty to <br />�, i�iafe or cancel the provis�ons olany other state cr local law reguPting ccnstruc6on or ihe <br />r,er,"crmance o/ consiruc:ion. Thsr I am authonzzd b}� (he owner o/ lhis prcpeRy to pertorm fhe <br />�,vcrk lor which appliCation is made and I comply �vdh !he State ConVaMCrs Law 19.27 RCW and <br />296.200 WAC. <br />I��� . ;�:. 1_ <br />-'i/� %'/J <br />