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ELECTRICAL PERMIT APPLICATION <br />CITY nF EVERETT PERIVIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9820 i <br />425-257-8810 - FAX425-257-8857-www.everettwa.org <br />APPLICATIONS ARE ACC''PTED FROM S AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�^ � - � �- ,_+ - �' � � � ( (',-.� : ,-r -'* ( <br />�1 � <� � � � , , � � , � ( _s<� ,�s:� _ <br />PROJECT ADDRESS <br />Tenant <br />•;!i,: 5.1.` jrc:��. <br />Mail Address <br />Mail .4ddress <br />,. ;,_<..�r:ni, <br />Ciry <br />Ciry <br />G•Jrc �d'�57 '��3'1-as}-] <br />State/Zip Phone <br />State/Zip Phc:ie <br />/ � �.- <br />cti.c�iUFi ��rlFr�ir F���ii �11���1�.. _,��—. ,=nt..�. i.�n ��v)'7C� ✓.'t"�-,`-�LY.� <br />Electrical Contraclor Mail Address City State2ip Phune <br />�-� I -/`i ,`z,: �. � <br />Stale License Number <br />Proposed Use of Building <br />J <br />Description af Work lo Be Dane: ��r . • � � �' � � " `�. �' <br />NOTE: 4VIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES i'A)C CODE IS 3105 <br />Contract Price of Work <br />Conta�t Person (Plan Review) <br />I hereby certily that 1 have read anr, examined this application and know the same to be true and <br />correct. All provisions o(laws anr ordinances govermng this type of work will be completed <br />wheGher speci(�ed herein or not. i he granting of a permrt does not presume to give ac:huriry to <br />violate or cancel the provisions o`any other state or/ocallaw regu/ating consfrucuon or the <br />peAormance ol construcGon. 7h��t I am authorized by the owner o( this property to perfcrm the <br />work (or which application is mace and I comply �vith the State Contractors Law 18.27 RCW ana <br />296.200 WAC. � <br />. <br />� %/� ���� ,_ � � .._. ( ( � I�.���� <br />r <br />FEE <br />�"� � "=- <br />�G �f�� � �'�' <br />