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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S i REET, EVERETT, WA 98201 7-'Z�i -0� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org ����� �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />!_�''��� ,S��a�`- 5%- <br />PROJECT ADDRESS <br />S-f�v:_.1 �I�ai l�c.✓ � j�/ Jiu��_ S�- Lo�✓Ur �✓�f 9`b20) <br />Owner A1ail Address Ciry State/Zip Phone <br />'�'���(� q ,�( <br />�d "C �/�`C <br />Tenant Idail Address City Stale/Zip Phone <br />nw✓1<r <br />Eleclrical Conlraclor Mail Address <br />Slale License Number <br />Proposed Use e( 6uildinp <br />Descripiion ol Work to De Done: �J� " �✓•+ •1'�- <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />aE IN RACEWAYS, MC OR AC CABLE. <br />C!7 <br />Gty Stale/Zip Phonc <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />r <br />/ . _ . . . ��-�`V�-� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certi/}� fhat 1 have rcad and examined fhis applicstion and know fhe same fo be frue and <br />co�recL All provisions ollaws and orAinances govem�ng Ifus lype ol �+�ork will he wmpleted <br />�rhether specilicd hercin or nof. The grantinq o/ a pernuf does nof uesurne to give aulhonty fo <br />violate or cancel fhe prorisions o/any ofher stafe or local la�+� regulafing consfn�cfion or fhe <br />pwlonnnnce o/ consWction. Thaf 1 am autho�ized by fho orcner oI this �ropetly ro �e�1��n� rne <br />work fr.r �rhich application is rttnde and 1 comp/y n•ith the Sfale Conhacfo� s Law 18.27 RC W and <br />29& 200 11�AC. <br />�, ` � � 1 %-=`1- ��i <br />FEE <br />F c�.c"l - l'��' <br />