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ELECT�ICAL PERMIT APPLICATlON <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982G1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� t.� �' � � � �I l�i <br />PROJECT ADDRESS <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C ��,��fj , �,i��� �) ��� %�- <br />_iv��i� L,� 6 1 �`' i�<n���>%i.r. �R Lvv,�-� l�l� `1 K;t�� �i=2��-`FI��� I�' <br />Ocrner Mail Address City S�atelZip Fhone <br />Tenant <br />L-��vr� <a; <br />Electrical Contractor <br />State License Number <br />���� <br />Proposed Use of Building <br />i�IUL 71�I <br />Alail Address <br />A1ail Ardress <br />City <br />Ci�y <br />StatelZip <br />State/Zip <br />Conlract Price of Work <br />Cor�tacl Person (Plan Review) <br />Desr.rip!ion of Work to Be Done: �� �� ���_J �� � i°.. � 1� �� _ <br />NOT�: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I he�eby certily Ihat I have read and exarnined this ap��licafion and kno�v fhe same to be true and <br />conzcL A!1 provisions ollaws and o�dinances govemmg this type ol work �vill6e completed <br />wheiher speci6ed heiein or noL The granGng o/ a permit does not resume fo give authenty to <br />violate or cancel fhe provisions ol any olher slate or /ocal law reguPting consfrucGon or the <br />performance o/ consfrucGon. That I am authorized by the owner o( this property to perform fhe <br />work Ior �vhich applicalion is made and I comply �vith t;ie Sfate Contractors La�+� 1R.27 RCW and <br />296.200 WAC. <br />' --, <br />��LI � � I U I <br />FEE <br />Phone <br />Phone <br />� 7'" <br />E ���2' <br />,3 <br />