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0 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 2` �' -� � <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �' i fY7 - G� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />2/ v� L{Gj i N � J�-.� GO / / <br />PROJECT ADDRESS <br />l�'� c{ S I/1 � N <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />.:U_c �'r= r�r��� ��c�� 2« <br />Eleclrical Contraclor Mail Address <br />�CY�TE � Od() �G <br />Slate License Number <br />S r' � <br />Proposed Use of Buildinc� <br />City <br />City <br />State2ip <br />Stafe/Zip <br />Phone <br />�/ � �, 7Phona <br />C/ <br />1�� !�a 332Z l 3L`� srS �-✓ L?'�/N <br />Description of Wark lo Be Done: �`% r�� /v�'"� <br />NOTE: WIRING IN NON-DWELLI�GS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />uS� <br />SlateRip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />1 hereby certily thaf I have read and exarnined this applicafion and know the same to be (ruo and <br />correcL All provisions o( laws and ordinances goveming this type o! work will be complefed <br />whe(her specified herein or not The granting of a permd does not presumo to givo aulhonty to <br />violafe or cancel fhe provisions o( any other state or local law regulating consfrucfion or the <br />perlormance o/ construcfron. T4at 1 am authonzed by the owner o( this property to pedontt the <br />work lor which application is made and 1 comply with tlio State Conhactors Law 18.27 RCW and <br />296.200 WAC. <br />���.� �r�� Z -I �- r l <br />Signalure Date <br />FEE <br />�C II 62-G5z( <br />Phone <br />