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ELECTRICAL RERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CCDAR 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 />I \ _ 1 . .. ._l'...J ' . 1 <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />i . � � � <br />Idail Address <br />A7ail Address <br />City <br />Cily <br />� �, " � . , �� �'� V �. �i <br />\ �'���� . L� — <br />[ledrical Contraclor � Maii Addr�ss Ciy <br />:. � _ i. , . , _, ,-t- <br />�� � . ( ; �� �_. ��J '. � � . . " ( � . J \ <br />>- <br />State License Number <br />Proposed Use ol Buildin� <br />�' A,` ' — ' l �'i-- <br />Stale/Zip <br />Phone <br />Stale/7ip Phone <br />I L� �.'=i�'h � � Ik�l� <br />Slale/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work l0 6c Donc: �� _ �� � �-��" �\�_l l��-�-� ���`���'�'���� <br />�a'.. . � . .. . . _ .- <br />NOTL: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />f3E IN RACEWAYS, MC OR AC CABLE. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi/y thaf 1 have read and exarnined tlus ap��lir,eNon and hno�v the same Ie be true and <br />correcL All pruv�s�ons o(lau�s and ordinances governmg this t}�pe o( work �t�i'I be completed <br />whether speal�ed hercin or noL The yranfing n( a pernut does nef n�esume ro give aufhonty fo <br />violate or carcel fhe pravisioirs o/any ofher state or local Intv regu�a(ing construcfion or (he <br />pedermance ol conslrucfion. That I am authorized by (he on�ner oI this properiy fo pe�fonn tho <br />�Yo�k lo�' �vhiCh eppliC�fiOn IS �11:Ide and 1 compl}� �vifh the State Contracfors Lan� 18.27 RCW and <br />296.20J l4�AC. <br />; ' � <br />Phone <br />�1C<:�1 � i�� <br />