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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 ACC�PTED FROM 8 AM TO 4 PM <br />,'`�o�� [_ v�',,, ������ �`�� <br />PROJECT ADDRESS <br />VP/C <br />i�, � 1��, � /� «. � y �� Y � � �o � �. � � y �;�„ �� P l-, <br />o������ <br />i;4f ft i �r1 <br />R1ail Atldress <br />c� t � <br />City <br />I�� <br />yga <br />Slate2lp <br />+-r N t, tt <br />�� G <br />�c�9 �/// <br />k <br />Phone <br />Tenan� Mail Address Gi�y StatelLip Phone <br />DLC �6o C,s�z <br />� �e� t, ,� 1-�,�. P.c.i�,;,, .�c �/V-���/Tew��� ��� 98asq �.�s3 <br />Electrical Contrador Mail Address Cily Slale2ip Phone <br />D�C � L� OIlO[, <br />State License Number <br />` 7� dG O <br />Contract Price of Work <br />l 6i�rw� u: t„}� J �� �' ��' i/ �.� ��-J /l/NC CnN�i� <br />Proposad Usc of Building Contacl Person (Plan Review) <br />Descriplion of Wnrk to Be Done: �'� ��� i.� fY C y ��'����5' ��/� �j, ��-(�� ��}YJ' <br />i �6 ' / / [) L �` . f <br />�� .?-C�CI :�_7Jf'�- C�r<'c���<�i�c�' ���cfJ: rlr�cr�/f �Y/l/�v�f �%/�/FJ�� <br />�l� ��) cit � �l �1 �' f <br />NOTE: WIR;NG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CnDE IS 3105 <br />1 herr,by certily that ! have read and examined Ihis application and know fhe same fo be (rue and <br />co�recL All prov�sions o! la�vs and ordinances governinR fhis type ol �vork will be comp/eteA <br />u�hefher specilied herein or noL The r�ranting ol a permd does nof ��esume to �ive auth �nty (o <br />violate oi cancel the provisions eI any ofher sfate or local la�v re�uPtin� construction or thc <br />per/onnance �1 construclion. That I arn aufhorized by fhe owner ol fhis propedy to pedonn (he <br />�vork lor wl�Ycli�ap��1�catr� i is made and I cornpty �vith fhe Sfafe Contractors Law iQ.27 RCIh� and <br />296.200 LNAC1,� 1 <br />FEE <br />