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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 g—�I �-OiQ <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ��8 _ � g� <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SZ I�,.• /N�n� � U�, C�Vk7�2eT1- wf1- <br />PROJECT ADDRESS � <br />,Ti1.r1�S L=' FALKNE� SZ. / G//�TvN Ac�� L�7/�pi G-'T% <br />Ownof Mail Address City Slate2ip Phone <br />H�S� ZtB� <br />89a6 <br />Tenan� <br />Elecirical CoNractor <br />State Lic�nse Number <br />No.�� <br />Proposed Use of Building <br />Mail Address <br />A7ai1 Address <br />Descriplion o� Worh lo �e Done: le E`1'� }G <br />... � : � ! � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAJ( CODE IS 3105 <br />Cily <br />City <br />Slate/Zip <br />Slale/Zip <br />Phone <br />Phone <br />Contract Price of Work <br />T��� FAl/��� <br />Contact Person (Plan Review) <br />1 heieby certily fhaf I have read and exarnined this applica(ion end know fhe same to be Irue and <br />correcL All provisions ollaws and ordin�nces governmg fhis type ol work will be complefed <br />�rhefher specified herein or noL The �ranfing o/ a penmf Aoes not presume fo c�ive atdhor.ty to <br />violafe or cancel Il�e !�rovisions ol any olher sfole or local lmv regulafing consVucfion or fhe <br />perfomiance o( construclion. Thaf I am oidhonzed by the o�sner oI tlus pruperty ro peAonn fhe <br />work lor which npplicalion is made and 1 cumply wifh the Sfale Contractors Law i8.27 RCW and <br />29& 200 WAC. <br />FEE <br />� <br />v �,lL� - I �c'' <br />