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ELECTRICAL PERMlT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STr�EET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� �? I 7 /�' � �_l�" l ` tj,'i [ ( � <br />PROJECT ADDRESS <br />l i'�, �� I d_i �. i � � r' ? 'T'ti ti-( I 7<<'' �<' �") 5 �C.(,� l; r"� -l�;r•X.� l�, ,4 C�c,-Z_'�j' <br />1 <br />Owne� Mail Address City State/Zip Phone <br />�' � <br />�,47 % <br />Electncal Contractor <br />�•� �r � ��.�. '�. <br />Mail Address " <br />%���'. <br />' Mail AAdtess <br />�� f l � > ��� i ',JiC"•'C•�• �� (,i l <br />Sta e License Number <br />..L' �:� �c ;'i�'� � (" <br />Proposed Use of Building <br />Description o( Work to Be Done: <br />; 17` %i. � ? '% I "� �6( <br />Ciry <br />__ ' .7'�.. i ��+� 9 C �7�/1.(C�. <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />�_ <br />�_ <br />State2ip <br />Slate2ip <br />� i— <br />Phone <br />Z i <br />Phone <br />`�� ��`, <br />Contract Pnce of Work <br />� `����� =i �" ��,�1� �("� <br />Contact Person (Plar. Review) <br />[.t'7i�. - ��`�"-7_ -i"`C-`�'�! <br />� f�,1- r' � tic Ii,t( C� �" <br />1 hereby certiry fhat I have road and examined thls applrcaf�rn and know the same to bo hue and <br />correct. All provisions ollews and ordinancos govemmg tl ,s type o/ work wdl be comp/eted <br />whefher speci6od herein or not The granting ol a pennd does not resume to give authonty to <br />violato or cancel tfre provisions o/ any other sfafo or Ixal law regoPahng construction or the <br />pe�fomianco o/ construction. That I am authonzed by the owner ol fhis property ro perform the <br />wod; Ior whiah application is made and 1 comply wdh tha Sfate Contractors Lavi 1827 RCW and <br />296.200 WAC. <br />,, � <br />—'= <br />._ ,lLr i <br />� � <br />C <br />FEE <br />��c�cr-�l <br />