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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREcT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />t���z--o 5 <br />E,:O SOL) '-�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - �EBIT & CREDfT CARDS ARE NOT ACCEPTEO <br />J�Ci`� — T�rnA-C�AC-� � I`�V� <br />PROJECT ADORESS <br />11��1q- So�+�sr,-� So9 - 1 A-,-1�c-nclL �_��:<<� �i�w3-4415 <br />Ownef Mail Address Clty StateZp Pho�e <br />Tenant Mail Address City StaleZp Phone <br />" �-1 zS-33S <br />Sd�o�tir.': ._">�"E �'Le�i-��c Pcd 2-!� S��ctio�-�tS� �18Z.9t ')7Sy <br />Electrical ConVactor Mail AEdress Gry Sta�eZp Phone <br />S�flohoE tt0 ('�..) <br />State Liconse Num6er <br />SF� <br />Froposed Uso of Building <br />Descriptionof Workto Be Done: _"�I � �` � ���' � � � �"�— <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3705 <br />ConVact Prica of Work <br />Contact Person (Plan Review) <br />FEE <br />Jrs', -- <br />1 hereby cer2ify fhaf I have read and examined Ihis applicatlon and know the same fo be frue and <br />correct. All provisions ol laws and o�dinances goveming this type o! wo�ic will be cornpleted <br />whether specified herein or not. The granting o! a pertnd does not presume to give authority to <br />violefe or cancel the provisions o/any otherstate orlocal law regulafing construcfion or the <br />peAormance of consPruction. That 1 am aofhonzed 6y the owner o( this properfy fo perform fhe <br />work lor which application is m�de and I comply wifh the State Confrac(ors Law ]8.27 RCW and <br />296.200 WAC. <br />�. <br />.5��`�- `� � <br />