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. <br />: <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FPJ: 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.-� Cf � (� � -� �`'(-�- � L <br />���� PI'�+=-M a-r- �T t Ec I <br />PROJECT ADDRESS <br />Owner <br />` /�� I Sf/ /a�i <br />Tenan( <br />1-16-0`7 <br />�e�n�-.og3 <br />Atail Address Ciry State/Zip Phone <br />Z'iJCF ..��/�il �'114�%/�UI 5i f-✓�Ck'i7 IJIS- �]c`��oi C.`i."��-�) (� <br />Mail Address <br />City <br />StalelZip Phone <br />�,F/\I��h c, 7 }-�K �i �:�� j Si`i I1 I•1 /�w� {� VC��.7 �J/1_ `j:�C ul �( �'' Ic%`. <br />Elecirical Conlraclor Atail Address City State/Zip Phone <br />State License Number <br />_f �/c'` <br />Proposed Use ot Building <br />,JS� .��:.i ��:�-_' ::�_ �t <br />Descriplion ol Work l0 6e Done: � <br />--'C`i-'��'-: C!'_. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />c_c, <br />/� ovo <br />Conlracl Price of Work <br />Contacl Person (Plan Review) <br />.�v:�ij- / L��L �� <br />FEE �= <br />�� 7a <br />I hereby cerlily that 1 have read and ea��mined this application and kno�r the same to be truo and <br />correct. All provisions o/ la�vs and o�dinances govemu�g fhis type o/ u�ork �� ill be cornplefed C � l C 1' C�., 3 <br />�rhether specilred herein or not Tho granfinc� o/ a pennd does not resmne fo give aufhonty (o <br />violafe or cance/ the prot�isions o( an}� ofhe� sfale or local la�v reguP(ing construction or the <br />per`ormnnce ol construcfion. That I arn aufhonred b}� the orrner o( tf�is properiy to pedonn fhe <br />�rork lor �rhich npplication is made and 1 compl}� �rith ttie SfaM �onfractors Law 18.27 RCW and <br />296.200 INAC. <br />� ( . . j �//G /c: `� <br />. .. � . . �• �. <br />