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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 />PROJECT ADDRESS <br />,�1.1l.WJ J' L��U 1���1 / LJ l(�/'.r �'�✓�'/�/L� �LL/f✓4L L'd"Owner <br />Mail Mall Address City Slate/Zip <br />Phone <br />Tenant Mail Address City Slate/Zip <br />Phone <br />ASS r1.:i4i� tle3tti /.>.i 6Z.A 1X:, .5.:.43^A71/ a),4 S?a/ 6/I>--.izP- <br />Electrical Contractor Mail Address City Slalsop <br />Phone <br />-45) zicxc t_- <br />Slate License Number Contract Price of Work <br />Proposed Vfie of Building Contact Person (Plan Review) <br />T <br />Description of Work to Be Done: �v/ l; , /�j`j i{ /!'lerc w9 3 t 3�1i <br />y�� ✓' !f <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify flint I have read and examined this application and know the some to be true and <br />correct. All provisions of laws and ordinances governing this type or work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the rowslons or any other state or local law regulatingconstructionor the <br />��on/s <br />work orawhich a o 11 made and comply twith thle Sfefe ConfrhalctorrsspLow 18 perform <br />PF 7 RCW and <br />296,200 WAC. <br />r <br />signature ate <br />E�� 03 -1 <br />