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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 5_ y�07 <br />425-2570 810 DA FF�X 425-257 8857 -rwww.eve?ettwa.org �� 7� Sv0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />, r,�'; <br />; '_) � �-5 � �i !11 �'� (� <br />PROJECT ADDRESS <br />N;-� r i E�`.�., , J <br />Ownef Mail Address <br />City <br />State/Zip <br />Phone <br />Tenant Mail Atld�ess Cily S�ate/Zip ,� Phone <br />��25 xY� cJ-)c�''; <br />�� �f� �.r�\T ELC��Tj'�� ��,�Cii �� 1F-�1`_J" �l- ('J�J j�1-7�11J-'�1-��j (.Jfi c%i21 2., / <br />Eleclrical Conlraclor Mail Address City Slate/Zip Phone <br />� Z <br />��I'����f,^, 1? j �r��� r� <br />Stale License Number <br />�, <br />S� �' <br />Pwposed Use of Building <br />-`�jliuu <br />Contract Piice o( Work <br />Contacl Person (Plan Review) <br />DescriptionofWorkloBeDone: /',��,til ��F.1-- �1y� ��rf� ��1�--1)iC,� <br />NOTE: WIRING !N 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 heieby ceriily Ihal I have read �nd examined this applica(ion and know Ihe same fo be true and <br />correcf. All provisions ollaws and ordinances c�overnmg Ihis type olwoik will be completed <br />�vhefher speci6ed herein or not. The �ranting of a pennd does nol resume fo give aufhority to <br />violate or cancel the provisions ol any other sta(e or local la�v reguPting const�ucfion or the <br />pcifonnance o/censhuction. Tiiaf 1 am authorized by the owner o(this property to pedorm the <br />work Ior �vhich application is made and 1 comply �vith the Sfate Contractors Law 18.27 RCW and <br />29G.200 WAC. <br />_, ��----- `�-'-l't! 1 <br />FEE <br />