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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425257-8857 — �wnv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />78� � Ever�✓.,�n ►�ay <br />PROJECT ADDRESS <br />Lant �r� <br />Owner <br />Tenant <br />ElecVical <br />pe�'�hrs �(,G t�515 �lev� <br />613�1 Atldre55 <br />•� /UDV ��/��.{�i�yV�-yy— <br />Idail ACdress % <br />�1G1 S7�Y1 �'C% � � � <br />�.�� ;,an A d�e55 <br />�NS�U.S� 55J�S <br />State License Number <br />Cct� a f�rs� i� <br />Proposed Use of Ouitding <br />Descr�pt�on of Work to Be Dore� <br />NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO <br />66 IN RACEWAYS, MC OR AC CABLE . <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />CAy <br />Cdy <br />y-a3 -+3 <br />��3o�r-o�7 <br />Vi%4 �'$�� <br />StalelZip P�or.e <br />State�� <br />� <br />StatelZip <br />vnone <br />P�one <br />� l� 250 — <br />Contrad Price of Work ��5 J <br />�'��7�msan 9,�•�ro9 <br />Contact erson (Plan Review) <br />c-ffw yv�� � i nsi5nius I�.c� <br />FF[ <br />,�G°� <br />I he�eby ceridy fhal I have read and exammed this applicat�on and knov� Iho same to bo In�e and <br />conacf AI! provis�ons o/laws and ord�nances govemmg fhis type ol work �wll be complINed ���j0�- —O �� <br />�vhelhc� speci(ed herem ornof. The granting ol a pemuf does not resume fo give aufhonfy lo <br />violafe or cancel Ihe piowsions ol any otRer sfafe or local la�v reguPhng consfrucfion or fhe <br />peAomiance nl c�nstiuction. 7hat 1 am aulfwnied by Ihe owner o/ fh�s property fo peAorm ���e <br />�vork lor wb�ch appOcaLvn rs made and I comply v.�rth flte Sfafe Conlraclors Caw iB.27 RCW anA . <br />296 200 WAC. <br />