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ELECTRICAL PERMIT ,APPLICAT'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STRE[T, EVERETT, WA 98209 <br />425-257-8810 - FAX 425-257-8657 •- vnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P�A <br />(- <br />� � � , N�f(;G U-_�r�� � <br />PROJECT ADDRESS � <br />Owner <br />ri � <br />Mail Address <br />Ciry <br />SWleftiP Phono <br />� ,l�i 1 ' I <br />Tenant MallAddress Clty Stelc2ip Pnono <br />��r <br />Electrical <br />MailAddresa <br />�r�t" `��%5 N�J1 � �`fi� C: 5 <br />State License Number <br />Propused Use of Building <br />Desuiption of Work to Be Done: ��F r <br />�% '� '��Yc��P ,�(' (;,('Sii^.� ' ci'- 5v5'�;�n-� . <br />-- i <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />8E IN RACEWAYS, MC OR AC CABLE. <br />Ciy <br />�ly�{ �c63�7D-3�U� <br />State2lp Phone <br />[_ Q � <br />V� <br />Contract Price ot Woik <br />�\�/',��4 �i�/��C � �'.�C� �,1 <br />ContaU Person (Plan Raview) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />p J �i�5 ` 1 _ V`'� �J <br />1 hareby certify that I have read and examined fhis a plication and know Ihe samo fo be frue end <br />correcL All pmvisions of laws and orrlmances govommg thi, type of work will be complefed <br />whethorspeaf�ed heroin or noL The granting ol a permd does no! prosumo to givo aufhonty to <br />violato orcancel fhe provisions of any othorslalo or locallaw rogu/ating cons(ruction orthe <br />performance o/consfivcG'on. That 1 am authonzed by fho rnvner olthis pioperty to peAorm the <br />work lor which app/icallon is made ond 1 comply wifh the Sfato Conhacfors Law 98.27 ftCW and <br />296.200 WAC. <br />SignaNre Data <br />