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ELECTRICAL PERMIT APPLICATION <br />CI�'Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 96201 <br />425-257-8810 - FAX 425-257-8857 —!•dww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />hh �� � �\/.�-r� � � ���_���--� �„�. �b 7 <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Cily <br />SlaleZp <br />Phone <br />\� I, <br />�✓�.�0 '\ \��l'� vt V� <br />Tenant Mail Address City Slale/Zip Phono <br />��'\� -C �� c� ��.��� — <br />Eleclrical ConUaclor Mail Address <br />�11�1��1s%s�� U�L�� <br />State License Number <br />C ���5 �1� .+LC � l�� n l,i <br />Proposed Use of uilding <br />Description of Work to Be Dono: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />S .°�� <br />Il <br />Cily Slate/Zip Phone <br />�-3�,�-bc.-�,a <br />� \ tav0 <br />Co lract Price of Work <br />�—X'un�i- ) �ic�' •.SG.� . <br />Conlacl Person (Plan Review) <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />! hereby certify fltat 1 have read and examined this application and know the same to be fruo and <br />correcL .JI provisions oflaws and ordinances �ovem�ng fhis type oI work will be completed <br />whether spec�fied herein or not. The c�ranfin9 c.`a permd does nofl�resume to give aufhority to <br />violale or aancel fhe pr'ovisions of �ny other slafe or local law re�u ating construction or the <br />performance of consWcfion. That I am aufl:orized by the o�vner o/ Ihis properfy to pedann the <br />�vork (or which application i5 made and 1 cornply �rilh fho State Contracfors Law 18.27 RCW and <br />296.200 l�A C. <br />% _ <br />� <br />FEE <br />