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ELECTRICAL PERMIT APPLICATION <br />�ITY OF EVERE7T 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 8,4M TO 4 PM <br />/ 2 y� � �7f-`� /''''�� `� �' Go T // <br />PROJECT ADDRESS <br />l�LL �/k�`J �ci/ri � jILP i <br />Owner Mail Address <br />Tenant <br />Mail Address <br />Ciry <br />City <br />Stala/Zip <br />State/Zip <br />►Z-'l�+' 1� <br />C/r��2�a� <br />Phone <br />Phone <br />C�/n.'r5 L2ex��'�c LL< <<�i9�,ldrt<<�.. �;�. i.�fXt'7rc+��.J7 Ir�✓r Q'�'a�� YZS 3iy3n�-� <br />Eleclrical Coniraclor Mail Address City State/Zip Phone <br />��/%l1/5 s=�. �jC�- I�,E <br />ilate Licr.nse Number <br />Proposed Use oi Buildinc� <br />Descriplion of Work lo Eic Done: �-✓ /��3 N��� �7��`�"` � <br />NOTE: 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 />Conlract Price of Work <br />ConlactPerson (Plan Review) <br />I hereby ccrti(y that 1 have iead �nd examined this applicalion and kno�v the same (o be true and <br />correct. All provisivns of la�rs and ordinances govennng this type ol work �vill be completed <br />ivhe(her speci6ed herein or noL ,The �ranting ol a pemut does nof presume to give aidhonty to <br />violafe or cancel fhe provisions olany other slate or local/aw regulating consfruction or fho <br />pe�formance o/ construction. That 1 am authorized by the o�vner o( thw property to peiform fhe <br />�vork /or which epplir,ation is made and 1 canply u�ifh !he Sfate Con6actors Law 10.27 RC W and <br />296.200 WAC. <br />� <br />i�`%� ���"��`"� j � /c�jl� <br />FEE <br />�� U � � � U��� <br />