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ELECTRICAL PERMIi 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 - DEBIT B CREDIT CARDS ARE NOT ACCEPTED <br />.;���1� 1 /�-� �`�� �l_ �� , fti � � ��r r� �� �;i� <br />PROJECT ADDRESS <br />. J�,` <br />Ownef <br />Tenant <br />,, r- ?('J� I�J�� <br />Mail Address <br />Mall Address <br />Electrical Contractor Mall Address <br />Slate License Number <br />J II 1;l ��.�,��.I �.,. ' <br />Propased Use of Bul�di�9-� -� <br />Clly <br />r,iy <br />� �A �.�f ��,�' <br />Slale/Zip <br />Slate/Zlp <br />Slale2lp <br />Contract Prce oi Wark <br />— ��, (�.'.{'i <br />_'rY' �`P�t�� _ <br />(�l�-.i <br />'�/"1-[ �,:� `� <br />Phone <br />Phone <br />Phone <br />j � <br />�� �i���.� � <br />Contacl Person (Plan Review) <br />Description of Work to Be Done: t �L '�� / �r �i ��i ," /(�'� ��' �` �' � � � , �",�' f . �•,�" f �r � l l _ <br />� � / <br />/ ` � PJ �.: ���.–, /'r t�� _`�. 1 <br />L'� S � ro,'�'� � �-� %i r � �,3 �r�Ii4^MS n��' � � / <br />NOTE: WIRING IN NON-DWE�LINGS IS REOUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby ceRily (baf I have read and examin�d fhis applicaFon end know the sama fo Ue frue and <br />correcL All provrsions o! laws and ordmances govemurc� fhis type ol work wdl be completed <br />whether specdied herein or noL The granting ol a permR does nof preswne to give authonty fo <br />violale or cancel fhe provisions ol any other stafe or local lew regu/efing construction or the <br />peAormance ol construction. Thet 1 em aufhonzed by the owner o! fhis property fo peAorm fhe <br />work lor which apphcation is made and 1 comply wrfh fbe Sfate Confractors Law 7A.27 RCW and <br />?96.200 WAC. <br />.�, �, -- J� <br />Signalu e <br />�G7-0/� <br />