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ELECI'RICAL PERMIT APPLICATION <br />CI�Y OF EVERETT F'ERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - -1X 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�;- � , , . I Yh L7� � � <br />r� � <br />PROJECTr�DDRESS <br />�� , _ <br />�y � <br />��, ' "'� (�i. � a .,�.� — c , >;�?. <br />L�� t.�C���l�_� _'-c�%%=i��_ �i_�_; 7>i.�� -5� � `.1.. .����a�'�'r, �.-� ie'r �� -�.1 <br />OWner L1all AdUress City State/Zip Phone <br />Tenanl <br />,��.� �,��L <br />� � <br />Electrical Contractor <br />h7ail :� ddress <br />�LvGl7��c. <br />��'� 5 ? l �/ `lS'F <br />Mail Address <br />l; ;�r. n: �r�� `j �� ; �v� �- <br />Slate License Number <br />S�� <br />Proposzd Use o( Building <br />City <br />City <br />Descriplion o( Work �o Be Done: �`� �' '�' �'�1"� �?�'� •" <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />� �7 <br />State/Zip <br />Ftate/Zip <br />Phone <br />`i�s ?;J 7L:uU <br />� '• v <br />��'OCi <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereb}� certily fhr:t 1 have read and examined ihis application and knou� the same (o be true and <br />correct. A/l provisions o/laws and ordinances governmg this type o( iverk �rill be compleled <br />ul�ether speci6ed herein or noL The gran(ing of a pennrt does not resume to give authority (o <br />violate or cancel the provisions o( any other state or local law reguPting const�uch�n or the <br />90 k loravfi ch �corl,catio��n a/ ae araid�l eon�orizedth t6eeState ContractorspLa�v 18P27 RCl4��and <br />296.ZOC WAC. P� � Py <br />� � , �ti� 2 � ) o o �� <br />Sinnature Dale <br />FEE <br />f-C;v� I�i/ <br />Phone <br />