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ELECTRICAL PERMIT APPLICATION <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 />� i .�l �I '� t '�, C,T S f_ ; !� f"� i,L ( �'}1 _�' <br />PROJECTADDRESS <br />l,V C�i�GLC�I' `�C�C�� <br />Ownor Atvl Address City Slale/Zip phone <br />Tenanl <br />Mail Address <br />Cily <br />Stalo2ip <br />Phone <br />�.�_� � C� � �Lc' Fr � < l/�1 %G 1 �C� cJ� / �� J % �'�c'�'4.ti'x.��� LUCa �!S'Z�r / �/ " �77 7 `l <br />Eloctrical CoNr;lclor Mall AUdmss City Slale2lp Phone <br />i� �41..(-c'� G .t �i ��/fi`). <br />Sla�o Licc�nso Number <br />��� �� ��, <br />Proposod Use ol [3uildin� <br />Doscription ol Work lo Oc Dono: I.� �l ���� <br />NOTG WIRING IN NON-UWELLINGS IS REQUIRED TO <br />�E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 13 3'105 <br />^'yl— <br />(�SOL`" <br />Coniracl Prlce ol Work <br />Cunlacl Person (Plan Roviow) <br />FEE <br />1 hc+iehy ��erf�ty fh�f 1lia� c reod nnd exanr7noAthis epplicnfion nnd know fhe seme (o bo hue and ��,.�, l� _ L� <br />con�cL illl provisions ol laws enA ordinnnces governing fhis typo o! worl� wiN be complefed �'� � I <br />whethei speci6cd h�rein ur nof. Thr �7rnnhn� ol e ponrut Aoas nuf /�roswne fo give authonty to <br />violote or canrel (he Im��isions o( nny ofhei sfnfe or locnl law repule(ing consfrucfion or fhe <br />pe�formnnce ol consiiuchon Thnf I nm eufhoiued by fho owner o/ fhis property to prAonn the <br />worA !or whir.f� opplicntion is mede anJ l conip/y w�lh Ihe Slafe Confraclors Law iH27 RCW and <br />29G 100 WAC. <br />`.� �Ic, "��i/� f���_ l/�4�/lL, <br />Siynature � Uale <br />