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ELECTRICAL 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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�'ci �) 7 �%>,�i2c/n/�1L- f-1���� - <br />PROJECT ADDRESS <br />� <br />Mail Address <br />Ci�y <br />G�'�1. �I�'Z�� <br />StalclZip Phone <br />y� I i <br />_ �ii %✓1 C Yi �' fl � �. <br />Tenant Mail Addiess City State/Zip Phone <br />�-� 1=� lt� `� l�i 5 i11'��I/t'i <br />Eleclrical Conlraclor Mail Address Cily State2ip Phone <br />Slate License Number <br />�'c;L� �,c,tlT� �.JC <br />Proposed Use of BuilAing <br />Conlracl Price of Work <br />Contact Person (Plan Review) <br />DescriplionofWorklo�eDone: �L -i4C �����7E"L �>/-�5� ��15[/�-, 1,'1.��%�7f'r��✓1�Y� <br />i� <br />�AJL! ��)/t'-� ' O�L' t'�'L� <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 3705 <br />FEE <br />1 hereby certily that I have read and examined lhis applicalion and kno�v the same to be (rue and <br />conecl. All provisions olla�rs and ordinances governmg this fype o/ �vork will be completed <br />�rlrether speciGed he�cin or noL The c�ranfin� o� a pernut does not presume lo give authority fo <br />violafe or cancel fhe provisians o/any ofher sfale or local la�v regulating construclion or fhe <br />perlom�ance olconsiruction. Thaf I am aufhorized by fhe ownero/ fhis propeiiy fo perform fhe <br />work for �vhich application is made and 1 comply �vifh fhe Sfafe Confracfors La�v /8.27 RCl1'and <br />296.� WAC. <br />, � i,.. .�1. ( L,+srG/,�'�/i � �/5/�`�„ <br />.E OsG9 -o� `i <br />