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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WF.98:01 <br />425-257-8810 - f=AX 425-257-8857 -- wwv�'.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �����`U <br />-;� � �'`' �/ �0� <br />_ r--� - ,�,�,'nr�.�,-*^ �`O�,iiJ z,�r� , <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Elecirical <br />' MailAddress <br />.�a r„ �` <br />Afail Address <br />��i� r /. 6'�C � c� lo <br />Stale License Number <br />Pruposed Use of �uilding <br />Description of Work to Re Done: <br />/ <br />�X%/1�F.C'Cit <br />M1iail Address <br />n�z,-� �ci,a l�l � <br />City <br />Cily <br />C�, /A�CF[J b �rc <br />cuy <br />cv��ni--� <br />�-. ��� <br />,I. � � <br />SlalelZip Phone <br />SlatelZiu <br />Stale�Zip <br />� <br />� % �U ' <br />Conlr2ct Price of lNork <br />Contacl Person (Pian Revie�v) <br />Phone <br />) )"„!% 7 / <br />Phone <br />NOTE: WIRING IN NON-DWELL.INGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERET'T LOCAL SALES TAX CUDE IS 3105 <br />I he�eby certi/; fhaf I have �ead nnc! ezamined this .�pplication and kno�v fhe same to be true and <br />conecL All p�ovisions o//aws anAordinances governing tlus type o(work �vill be compfeted <br />�vheUier specdied herein or not The c�ranting o( a permrt does not presume to give aufhonty to <br />violaie or cmicel Ihe provisions o� any other sfate or local la�v regulafing construcfion or the <br />per%rmanr,e ol ccnstrucfion. Thaf I am aulhorized by the ou�ner o( this property to perlorm the <br />�vork !or �vhir.h applic�hon is made apd 1 cornply �vith Ihe State Con6�acfors La�v i827 RCW and <br />296.Z00 WAC. // <br />; <br />! ,�-��. <br />,/ i /, / ' ' <br />f <br />va�e <br />FEE <br />�� ��-�j�l <br />