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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, lNA 98201 <br />425-257-&810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�c-�l.! c' 11'�C bC`.�� �,� a iqv C� <br />PROJECT ADDRESS <br />Owncr <br />Tenanl <br />Electrical <br />� 1hN�'I�.�',�(�f �- <br />State License Number <br />Mail Addres5 <br />Mail Address <br />Mail Address <br />f�t'.f��cC ��"i j, i. S�rliO n`Y� <br />Proposed Use of Buil�g <br />Description of Work to Be Dona <br />5 <br />NOTE: WIRING IN NON-DW[LLINGS 15 REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />Slate2ip <br />� ��o io <br />� /OD �1-0�3 <br />Phone <br />Slaee/Zip Phone <br />3 fOU <br />U!� ��C2�� G=7/ -/3 <br />Cil� Sta1e/Zip Phone <br />S 6t�0 ..� <br />Conlract Price of Work <br />�lfi l� �.�/`�-1i�— <br />Conlacl Person (Plan Review) <br />C't <br />ce�iily fhaf 1 h,�ve read and examined this applicalion and know fhe same to 6e Vue and <br />All piovisions o/ latvs and ordinances govenung (his fype ol work will be complefed <br />specilied herein or noL The c�ranfin� ol a perrnd does not presume to give authonty fo <br />� cancel fhe �rovisions ol any other slate or local la�v regulating construction or fhe <br />�nce o( cons��ucfion. That 1 am aufhorized by the oroner ol fhis property lo periomi the <br />�a:hich application is nrade and 1 comply u�ith fhe State Contradors Law 78.27 RCW and <br />y���G i �l� <br />FEE <br />.�- <br />;� ) �'-/ -���3 <br />/ <br />