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ELECTRICAL PERMIT APPLICATIO�1 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l %y�'% %7f� /ivo � � <br />PROJECT ADDRESS <br />'l�i t i=./5 ilr r'�'/ ;�'•'�'i <br />Owner <br />l"enanl <br />Mai; Address <br />Mail Address <br />City <br />City <br />State,'Zip <br />Slale/Zip <br />� Z _a-, ��o <br />%� � r / Z �.1 ji� <br />Phone <br />Phone <br />C���S /:lG-r�7ZC L�c «�/! l.sY�/-"t�'v f-'%� L.t{�is7but�'i W✓r 9�15�'S' y:'S �%��c <br />Eleclrical Contractor Mail Address Cily Slale2ip Phone <br />(� //Y'%5/ < <%�Z_ Jt <br />State License Numbcr <br />Proposed Use o( Building <br />/�ZG� �o <br />Contract Price of �Vork <br />Conlact Person (Plan Review) <br />Descriplion o( Work to �e Dono: 1� /� �" /L�L'�^� �l"l'���^ l- �����'� <br />NOl'E: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE W RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat 1 have rend and examined lhis applicafion and kno�v fhe sarne fo be fruo and <br />correc(. All provisions o//au�s and ordinances �overmng this fype ol �vork �vill be comp(efed <br />whefher spealied Herein or noL The granting ol a perrnd does nof resurne to give authonty to <br />violafe or cance/ the provisions o(any other sfate orlocallaw rec�uPting consfruction or the <br />pe�forrnance of cons6uc6on. That 1 arn authorized by the owner o/this property fo perform tho <br />n�orl< Ior u�hich application is made and 1 comply �rifh the Slate Confractors La�v 18.27 RCW and <br />296.200 WAC. <br />', �� -�,�:-� / 7/7 �/ i o <br />�i <br />FEE <br />�1ui �� 15� <br />