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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 425-257-8257 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3ZZ3 �Je�mote. ;��e � 3ola <br />PROJECT ADDRESS <br />q -a�-o s <br />Co 5o9-i�q <br />C'o,rF`�,�e.,.�,1 �J�.z� �z'3 ��« �=.,� �.��, ��Za� <br />Owner Mail Address City State2ip Phone <br />Tenant <br />Eleclrical Conlractor <br />u�rt���9� i rJT <br />S�alc Licmise tJumber <br />Proposed Usc of Buildin9 <br />Mail Address <br />Mail Address <br />Descriplion of Work lo Be Dona ll 7v <br />NOl'E: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />i rE. <br />SlalelZip <br />SlalelZip <br />Phone <br />1 t,�i� 482? <br />Phone <br />"+ )-S 740 � 1'{ <br />�, Z ��O d . �6 <br />nlracl Price ofWork <br />� �l� .� �'��.r-� <br />Conlacl Person (Plan Review) <br />FEE <br />1 herehy certily Ihaf I have read and examined Ihis applicnlion and know the same fo be true and <br />correct. All provisions o/la�vs anAortlinances �ovemin� Ihis type ol wo�k u�ill be completeci <br />�vhether specilied herein or noL The granting o/ a pennd does nol presume fo give aufhonty lo <br />violate ar c�ncel Ihe provisions ol any other state or local lau� re9ulafing ccrisfruction or fhe <br />pedonnancc o� r.onsiruclion. Thaf 1 �nt aulhorized by fhe owner oI this propeiiy fo perlorrn the <br />�vork lor �vhich applicafion i�nade ar�! comply �+�ifh fhe Ste�fe Contracto�s Law 78.27 RCW and <br />296.200 WAC. i7 / / <br />i/Ld �'Z I-D� <br />Date <br />