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ELEI�TRICAL PERMIT APPLICATION <br />CITY OF EVERETT P�RMti SERVICES <br />3200 CEDAR STREET, EVERET'f, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROI',� 8 AM TO 4 PM <br />>>C�OY S/ I'L�c�� s�.v <br />PROJECT ADDRESS <br />C/ii�.! 2,`Cld.-'i7(�5��✓ S��,a- - <br />Owner Mail Address Cilv Slale2ip Phone <br />Tenanl <br />Mail Address <br />Ciry <br />7 <br />Electrical <br />1�/Z� n-7/ILL G7 / 3�' C <br />Slale License Number <br />.- r a? <br />Proposed Use o( Buildinc� <br />Mail Address <br />City <br />DescriptionofWorktoBeDone: i=-= Ci.�._i� fz�V.��;«� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC GABLF. <br />CITY OF EVERETT LOCAL SALFS TAX CODE IS 3105 <br />Slale2ip <br />State/Zip <br />� TOO� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I heraby cerfily Ihat I have read and examined fhis application �nd know fhe same to be true and <br />conecf. All provisions ollaws and ordinances �oveming fhis type oI work will b�� completed <br />whether speafied herein or noL The granfing o� a permd does not resume to oive ao!honty to <br />violafe or cancel fhe provisions o! any other state ur local law re�uPtint� constri ction or the <br />peAormanc� o(cunsfiuction. That I arn authorized by the o�vner o/ fhis propeR� to perlorm fhe <br />w�ork for �vhich applicafion is made and I compty wifh the State Contractors La�� 78.27 RCW and <br />296.200 WAC. <br />. _ _. � / .. %: ,, /_ l <br />FEE <br />Phone <br />Phone <br />E c�c�oZ-�a3 <br />