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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ��� 9�io <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.orq �/0// _ OL/(� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />���}I, �-I S r� <br />PROJECT ADDRESS <br />'��.i��� <br />Owner <br />Tenant <br />! <br />Mail Addross <br />Mall Address <br />� <br />I <br />Cily <br />� <br />� � �, � .� l, '� j'�, iK �`�( ��� �-�r _ <br />Eloctrical Conlractor � Mau Address Clty <br />j� r � <br />i - .,�i, l�� � �t <br />Slato LicAnso Numbcr <br />Proposed Use ol Duilding <br />Doscriplion ol Work lo f�e Dun��.: _ <br />r </i / �</r <br />NOT[: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />f3[ IN RACEWAYS, MC OR AC CADLE. <br />,,� , <br />Slate2lp <br />S121o'Zlp <br />�, ( U�L�� <br />State/Zip <br />Contract Prica ol WorY. <br />Phono <br />Phonc <br />'7?c � i`%5—//'( <br />Conlact Person (Plan Review� <br />CITY OF EVERCTT LOCAL SALES TAX CODE IS 9105 <br />1 hrr��by cr.rfi/y fiiaf I have reerl flnd examined Ihis applicafion und knoN Ilre senw fo bu fruo and <br />r.anect All provisions ollnws anAo��fmmices go��ermnp this fype o! �roik �+�ill bo caruploled <br />�rhrffier specilieAherein or noL Thc �rnnfinc� o( a pernut does nofl�wsume to pivo aufhonty fo <br />v�olate er cancel tho `�rovisiuns o/nny other sh�fo or lecnl lmv ror�u nfing conshuchon or fhe <br />prrforrnance olconstruction. Thaf I am eufhonzed by fhe owner o/fhls property fo porlomi Oie <br />�ro�k lor �vhich applicntion is m.iAo nnd I comply �vith fh� State Contractors Lew 18.27 RCW anA <br />?9G200 WAC. <br />/ ' <br />` " --�i�.- ' _ <br />' G�;�;,i����. •_-- — <br />r <br />�1-�/ <br />'_�—. � <br />FEE <br />Phona <br />��� �_ oUy <br />