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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S?REET, EVERETT', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v✓ww.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� <br />!-�112_ �>�!L�.r�� �GF '���,��c.� WE� ���Z� � <br />� <br />PROJECT ADDRESS <br />��_Cc �'r �C-�����t>I�._'�i�N ��'�� �c� {�U� ��S^ �'i., `-i'i� L'�i'1 �i`1����) !/��'j���5'��44ys <br />Owner t.lail Addmss Cit� S�ate�Zip Phonc <br />Tenant <br />Electrical Coniraclor <br />1 <br />�C �C�lr�/J; <br />� L <br />Slale License Number <br />Proposed Use o( Buildinc� <br />t.1ad Addicss <br />t.lail Addiess <br />City <br />City <br />Slale/Zip <br />StatelZip <br />Conlract Price of Work <br />Conlacl Person (Plan Revie�v) <br />� <br />Descriplion of Work to Be Done: ��\ �� `� �� �1��"'� <br />, <br />"x%�_� -r ��;��f- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE, <br />CITY OF EVERETT LOCAL SALCS TAX CODE IS 3105 <br />1 he�eby certil}- fhaf 1 have read and exanuned ��.s application and kno�v the same to be t�ue ano <br />r.orrect. All provisions ol lmvs and ordinances yrverrun� fhis type o/ n�ork u�ill 6e cempfefed <br />whether specilied herein or nol. The granfing ot a permd docs not presume to give aufhorify to <br />v�olate or cancel the provisions olany ofher srate or bcal law reg�Jafing consf�uction or the <br />periomranc. o/ construction. That I arn aufhaimd by the owner o7lhis property to peAorrn Ihe <br />�vork lor �vh ,h application is rnade and 1 com��ly �vith the Sfate Confracfors La�v 7827 RCW and <br />296.200 W C. <br />f r. <br />� �1 <br />�� '� �. �.,-�� �,/� �'� � V \ <br />s� G{ �� � � <br />" ISiqn� Date <br />FEE <br />'�c�io� i3�s <br />Phone <br />Phone <br />