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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3'L00 CEDAR STREET, EVERE�f-f, WA 98201 y`)6,��7 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��p�6��0�.5 <br />APPLICATIONS ARE ACCEPTED FRnM B AM TO 4 PM <br />, � <br />�L - <br />� �/ �c�.;. ,, � ri , � <br />PROJECT ADDRESS <br />� � <br />I./Ic�I"' ,��� •J�' <br />Owner <br />Tenant <br />� <br />D %_ <br />Electrical Conlractor <br />Slate License Number <br />Use of �uilding <br />M1tail Address <br />Mail Address <br />Atail Address <br />� <br />City <br />City <br />City <br />State/Zip <br />State2ip <br />Slale2ip <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />Description o( Work to Be Done: /V-t � i�C.' �� Uil'iV� c�-2 h✓ jG --e �}'2 Gvi h'� <br />/�.� <br />l�%:'J')�`7. �01 � ��DU.S--� . <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT L�JCAL SALES TAX CODE IS 3105 <br />I hereby certi(y that 1 have read and exarnined this application and know the same to be true and <br />correct. All provisions ofla�vs and ordinances goveming this type oI �rork will be completed <br />whether specified herein or not The granting o( a perrnd does nof �resume to give aufhonty to <br />violale or cancel the provisions ol any ofher stafe or local law regufating construction or ihe <br />peAonnance ol construcf�on. Thaf 1 am aidliorized by fhe owner o! this property to perform the <br />work lor which applica!ion is made and 1 cornply �vifh fhe Sfafe Contractors La�v 18.?7 RCW and <br />296.200 WAC. <br />./ �j/" f / ��l <br />_ �-_%%l'Z-�-�. � �li ";>�,,�� :Z—/ J"D '/ <br />FEE <br />t':CiioZ C� �j <br />Phone <br />Phane <br />Phone <br />