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ELECTRiCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 6-'a 7-" y <br />425-257-8810 - FAX425-257-88E7—www.everellwa.org C ���6,���(� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />f�-� 7�� �i, L�. ����-��,/c�� �� � z �/ <br />PROJECT ADDRESS <br />�'%�; cY �, �/j ,.�,iy. <br />Owner <br />Tenant <br />� <br />Eleclrical Conlraclor <br />State License Number <br />�f� �� -���, ;��. �. � <br />Mail Address <br />Mail Address <br />� <br />Mail Address <br />��� f1 �g��� <br />Slale/Zip <br />Stale/Zip <br />Stale/Zip <br />Cor.lracl Price of Work <br />yzs-'>U <br />c� // . <br />Proposed Use of Building Contacl Person (Plan Review) <br />� ;I� �^ , I <br />Descriplion o( Work lo �o Dono: �N �� 1�� `L � � *�E'_. �V` s� G I `�( (�?V� {��-°t.� <br />=1G <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y fha(1 have rend and exarnined this application and know �he same to be true and <br />curracL All provisions o(la�vs and ordinances yo��ernme� this type o( �rork �vill be complefed <br />:vhefher spea6ed herein or noL The grantin� of a permd does nof �resume fo give authonty fo <br />violafe or cancel the provisions o(any other stafe or local la�v regul�fing construction or fhe <br />per(ormance o/cons(ruction. That 1 am autho�ized by fhe o�vner o/ Ihis property to perforrn the <br />�roork lor which applicafion is rnade and 1 comply with the State Contracfors Laiti� 1Q.27 RCW and <br />?.9G.200 � C. /' <br />�( �", � -- ./ �I <br />. ��—� �-� /�/c,•c. Ijl� / �l — <br />. _. . Yn..r,. / <br />Phone <br />Phane <br />Phone <br />FEE <br />�I��L �- ��:,1 <br />