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ELEC'TRICAL PERMIT APPLICATION <br />./ /�� �'/ <br />� J <br />PROJECT ADDRESS <br />/�/c7, y/['T � C/ <br />Owner <br />Tenant <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 />i7 .J 7 .� /��i � <br />-�j7 ��' ��,' 7jc�:- <br />�—� , i% r r - _ <br />Mail Address <br />Mail Address <br />City <br />Cily <br />.� O i <br />Stale/Zip <br />StalelZip <br />�'G7'zi�-��/ <br />Phone <br />Phone <br />�v i..�, �i. �.i � o '� _�r : c � �3�p / ,CLc �� c �lf%-c �'��� � �? O/ �fZS -7_��/-2 <br />E� ctrical Conlraclor Mail Address Cily StalelZip Phona <br />��_, <br />L.—L�../�/(,• `�j�,�� �- L�-j�"7 �C��� <br />r` <br />Slale Li�;ense Number Contracl Price o( Work <br />� �� > <br />Proposed Use of Building Contact Person (Plan Review) <br />Descriplion ot Work la Oc Donc: � �" � ' �� � '' ��' " <br />,� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />EiE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVFRETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi/y thaf 1 have read and examined fhis app�icalion and know fhe same to be true and <br />conecL All provisions of laws and ordinanr,es sovernin� this type oI work will be completed <br />whether specified herein cr net The granfing u( a pernut does not resume ro give aufhonty ro <br />viola(e or cancel the provisions olany other sfate or local law �e�uPfing construction or the <br />psrlormnnce oI cons(n�ction. Tlra(1 arn authorized by the o�vner o( fh�s properiy to pe�(onn the <br />nork lor which application is made and I comply wifh fhe Sfate Contractors Law 18.27 RCW and <br />296200 WAC. <br />�c � �_� . ) � , � <br />� _ J �� / <br />, �% � <br />FEE <br />� �n�� ��� � <br />� <br />