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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 />t <br />S � �, S / � ° � � J,(�! <br />PROJECT ADDRESS <br />C'�{R�� ��2��CS���1 S1( 51'r51 v.�a .�UERE� LiJQ�nG.i-�v <br />Owner Mail Address City Slate/Zip Phone <br />Tenant <br />Mail Address <br />ac,�r�� r,y"`.�A oc.,J w <br />_ a-s Pr,f3►qg � <br />Mail Address <br />� � _ r� ��. �5 t�� <br />��- � ; <br />Slate License umber <br />R�s.l�n)TrF L <br />F�roposed Use o( Buildinc� <br />Description of Work to Be <br />� , ' / i <br />j ' ; ) .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 3105 <br />Cily <br />State/Zip <br />2 3c,h- <br />Phone <br />City State/Zip Phone <br />°9 ���o�� <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />�.. � n_ /) .. .__.. <br />1 hereby ce�tily Ihat I have �ead and exarnined Ihis application and know the same to be frue and <br />co�recL All p�ovisions o/lews and ordinances govemmg fhis type o( work will be complefed <br />whether specilied herein or noL The granting o( a permd does not resume to give aufhonty to <br />violafe or cance( Ihe provisions ol any cther sfate or local law reguP(ing construc6on or the <br />per(ormance oI construction. That 1 am eufhorized by the owner of this property fo peAorm the <br />work lor which application is made and 1 comply wifh the Sfate Confracfors Law 1A.27 RCW and <br />296.200 WAC. <br />FEE <br />