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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES v �� s,:o!/� <br />3200 CEDAR STREET, EVERETT, WA 98201 L <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org g� 7.�p'7 <br />2�fC ��t� <br />PROJECT ADDRESS <br />Owner <br />r ''7� <br />� � I 1' V� � <t I�-, <br />Tenanl <br />W�JilE �1 <br />Electrical Cunlraclor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5 fi ��.� r�� t� <br />f�.lail Address <br />zil (� <br />Mail Address <br />rS��s <br />hlail Address <br />!�v��� T� '� y 933 l�P <br />Slale License Number <br />Praposed Use of Buildiny <br />Description of Work lo Be Done: <br />City <br />c g�t4 sfi <br />City <br />Fr �� Y <br />City <br />NOTE: WIRING IN NON-DVVELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />State2ip <br />�..�� rl' t � :ti <br />Slate/Zip <br />Slate2ip <br />Phone <br />�Zj'_ z��--IK� <br />Phone <br />� zr <br />u�A — %��-��6, <br />Phone <br />� 3 so. `,� <br />Cont�.,ct Price of Work <br />��% MY�ti � <br />--� <br />Contacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hr.�eby certil}� fhaf 1 have read and examined this applicafion and kno�v fhe same to be (rue and <br />cnrrecf. All provisions olla�vs and ordinnnces governrng this type oI �vork will be completed <br />�vhether speci6ed herein or noL The granting ol a pennif does no; presume fo give authorrty (o <br />violate or cancel the provisians oI any o(her stafe or local la�v iegulating consUuc6on or the <br />pe�formance of construc6on. That 1 am a�dhorized 6y the a�rner ol this property to perfonn the <br />�vork lor which applica6on is made and I complv n�ifh tlie State Confractors La�v 18.2/ RCW and <br />296.200 WAC. <br />, ,� ' , •�,,,� � <br />;�; ;�c��z-; , s�� e�7 <br />� � �, i <br />FEE <br />���,Z _ �� I <br />