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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,� �( � `/ S� <br />PROJECT ADDRESS <br />��..; itiT�j���l� <br />Owner <br />.S� �^^ ` <br />Tenanl <br />�,� ,<� Z�;1 <br />Afail Address Cily <br />•\5 fi 3Q�S(= <br />hlail Address <br />�r� o-t-f �. � � , v-e .\ � � � �-t" <br />Electrical Conlraclor Mail Address <br />lL.,�?I� 1���� ��Z J S <br />S'ale License Number <br />/< i S� r� �',.-i c: < <br />Proposed Use of Building <br />Description o( Work la Bc Done: �( r L� �. c�- <br />City <br />f,L lSo K <br />Cily <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />1 (�a <br />S�vi� .-� <br />State/Zip <br />��] Z �' r' <br />yLs= �/l� <br />Phone <br />State2ip <br />1773 fw�.e,.�.�,t� ��� <br />Slate/Zip j�'2 j'/ <br />Contract Price of Wor� <br />�: ) <br />:fT"�w. /� �.t.. <br />Conlacl Person (Plan Review) <br />�+-��t r. c" c:� CIT <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat 1 have read and examined fhis applicafion and kno�v the same to be frue and <br />correct. All provisions o/la�vs and ordinances govemuig this type o( �rork will be complefed <br />whefher specdied herein or not The granting o( a pennd does nof resurne lo give aufhonty to <br />violafe or cancel fhe provisions ol any olher stafe or local law reguPting construcfwn or the <br />performance ol construc(ion. Tha! 1 am aufhorizeAby the owner olthis property fo pedonn the <br />work lor �vhrch application is made and 1 comply with the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�\ i <br />-l� G�, <br />Phune <br />�zr�z�;l � <br />Pho�e <br />FEE <br />� � <br />��� <br />'a i l � �� <br />' C� I <br />� <br />