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( <br />ELEGTRICAL 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 ��,,, a—/b <br />APPLICATIJNS ARE ACCEPTED FROM 8 AM TO 4 PM ��Q/Z'-� �� <br />Li �� �,�,-,�ti l�- <br />PROJECT ADDR SS <br />I �� r <br />Owner <br />Tenanl <br />q <br />Slale License Number <br />_.C� ��� <br />Proposed Use ot Building <br />Description of Work lo Oe Done: <br />� <br />Mail � <br />Mail Address <br />��i� i/ Sf <br />Mail Address <br />s�- � o �ie 1-/ <br />Cily <br />City <br />- .S! � L'i�r'i�'��- <br />City <br />���v %d1�',Y <br />Slale/Zip Phone <br />Stale2ip Phone <br />•i / `!I!O <br />Slate/2ip <br />Contrect Prico o( Work <br />Contact Person (Plan Roview) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby ce�fi/y Utal 1 have read nnd exarnined fhis applicatior enA know fhe sarno fo Ge frue end <br />correct. A/l provisions ollaws and orriinances goveming fhis fypo o! n•o�k n•ill be comp/eted <br />�rhefher speci6ed berein or' noL The granting o/ a penmf does no( �resume to give authoiity fo <br />violafe or cancel ffte rx�o��isions o/ arp� oflier sfafe or lor,al law regulafin,q construcfion or fhe <br />pedonnancr, ol conslrucfion. Thaf 1 am authonzeAby the o�rner o/Ihis property lo perfannlhe <br />work !or which application is made and ! wrnply rvifh (he Slafe Contractors Lnw 18.27 RCW and <br />29G.200 INAC. <br />Phone <br />�rl, / 07 — i�/� <br />� ��b <br />