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� <br />! ELECTRl�AL P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8a57 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��7r'�� i � � Il � ( \ � �% r �> <br />PROJECT ADDRESS <br />/� n y z � <br />�.�ai =�,a,�1� jl�.,?�tS .� nc� . l'" Jk�x f-;�l�`� U� STct-�Y�) 5�'�� 3�c"��� <br />Owner 61ai1 Addmss Cily Slale2ip Phone <br />Tenant <br />Electrical Conlractor <br />Slale Licensc Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Ci�y <br />City <br />Description of Work lo De Done: ��i � /�L1(,U�-'�`�' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE i? LOCAL SALES TAl( CODE IS 3105 <br />Slate/Zip <br />StatMZip <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />I hereby cerlily tAaf 1 have read and exarnined Ihis app6cotion and know fhe same to te true and <br />correct. All provisions ollaws and ordinances governmg fhis type ol work will be comFlete� <br />whefher speciGed herein or noL The granling o/a pemuf does not resume to yive au'honty to <br />vio/afe or cancel the provisions o/any other state or ocallaw reguPting construc6on cr the <br />pedormance of consVuc6on. That I am aufhorized b i the owner ol thrs propeRy to perlorm the <br />wo�k Ior which application is made and 1 compty �villi ihe State Contractors Law 18.27 RCW and <br />29ti.200 WAC. <br />�� <br />FEE <br />1 '^ J <br />n' I fli <br />ri, v <br />Phone <br />��TdiCd <br />