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ELECTRICAL PERMIT APPI�ICATION <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 />`�1� `�9�5. <br />PROJECT ADDRESS <br />�� �" <br />� 5 '.��_ t� <br />Owner <br />Tenanl <br />,� \ ' <br />� . ��� y�i- '.�. ,_� <br />Electrical Conlraclor <br />� �� <br />Mail Address <br />Mail Address <br />G � /"�-��''_'. l ;�" <br />Mail Address <br />� <br />i�� c F� �r,� �i � ��� �- �� r � <br />Slate License Number <br />�'" .� �� <br />J -i <br />Proposed Use of Building <br />City <br />Ciry <br />SlatelZip <br />State2ip <br />� a -�7-�0 <br />Clolz--1(q <br />Phone <br />Phone <br />;,�1 ����,��_ (L., �—'�vfl/����v�� <br />Cily Slale/Zip Phone <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />� — <br />Descriplion of Work lo De Done: � �� � � � �'" "� f' � � � ` `� � �' �� � � <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 />1 hereby certily that 1 have read and examined this application and know the same fo be true and <br />correcL All provisions o(laws and ordinances governing this type o( work will be completed <br />whether speci(ied herein or noL Tbe granting of a pe�md does not �resume to give authonty to <br />violate or cancel the provisions ol any other stafe or local law regulating consfruction or fhe <br />periormance o(construction. Thaf 1 am aufhcnzed by fhe oK�ner o( fhis propeRy to perform fhe <br />work lor which application is made and 1 comply wifh fhe State Contractors Latv 18.27 RCW and <br />296.200 WAC. <br />� � � �?_ ��� <br />r�,..�_ J;� ;�_ <br />FEE <br />C �ar�--l�l <br />� <br />