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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 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/D -5 -�1 <br />C0��0 -!�7 <br />- ,� i ( ��,.!� �V�/� l;.�Z � <br />PROJECT ADDRESS� <br />;'�h,,',_ .-�!� �' <br />/ � <br />�� � <br />5 � �i: � ,�'�(z � L �_��� �:. _ u �� ,-, >"G�r � � �, -�> � � � i � � '} � � y ,� 5 33 k',�� <br />Owner Mail Address Clty State2lp Phone <br />Tenanl <br />C -' L�' , �� `i �� <br />Eledrical Conlracbr <br />iv' . .� <br />Stalo Licensr. Num6er <br />Idail Addiess <br />Mail Address <br />Cily <br />Ci�y <br />Slate2ip <br />51ate/Zip <br />Contracl Pnce of WorY. <br />1 <br />�� �t <br />Proposed Use of [3uildin,y Con�act Person (Plan Review) <br />� 1 7 <br />Descriplion of WorV, lo Oe Done: � � � � tr�� � �.) �Z.. �L'�--V � �� ��.L' S( i) �i �' j . [. y �_ <br />����' � VU� �, � ei � p �� �' � <br />���c� << ��.( ; �� �.�, , �� <br />NOTL. WIRING IN NOIJ-DWELLINGS IS REOUIRED TO <br />�C IN RACEW1IYS, t�1C OR AC CAF3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby certify U�at 1 have rcad nnd ea�aminr,.d this applicnfign ;�nd hno�r the sanre to Le true and <br />correct. All provisions o(laws and ordinanres govertuny fhis type ol �rork will be completed <br />�rhefher spealmAherein or not The grantng o/ a prmuf does nol �resume to gire aufhon(y fo <br />violafe o! canr.c�l fhe pravisions ol arq� other sfafe or local law �egulafing consfrucfion oi the <br />perfomiance ,`consiruc�ion. Tbat 1 arn author��d by the cwner o/ fhis pmpeAy fo peiform fhe <br />tvork lor �rh,ich application is mnde and 1 compl}� �rith fhe State Confroctors La�v 18.27 RCW and <br />29C>.200 WAC. <br />�.. � ' ;� ' L � � <br />FEE <br />LJ�{�V 611 <br />Phone <br />Phone <br />