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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 — wv✓w.everettwa.org � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`�rZ �t/ /3roa� ��. �- <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Mail Address <br />�--� �%�N � � <br />� Mail Address <br />City <br />Cdy <br />ti'[.� �CT7�'Ic S�'�'V(CES /NC 3z �/y���kV65w <br />Electrical Contraclor A7ail Address Cily <br />N�v EL L� SQzS�L <br />S�ate License Number <br />IF'��/c1(.. MoTo �.° I N1✓ <br />Proposed Use of Ouildin� <br />Description oI Work lo �c Duna /� <br />' E N�e�.J , <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />f3E IN RACEWAYS, MC OR AC CABLE. <br />StatelZip <br />StalelZip <br />SlatelZip <br />Phone <br />P�one <br />23 ���� �� <br />Phone <br />� ��v <br />CoNracl Price ol Work <br />CoNact Person (Plan Review) <br />/JN, L,'l/, t <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />1 here6y certil}� Ihaf 1 have irad anAexamined (his app6,:ation anA know fhe same fo be We anA <br />conect. All provisions o/la�vs and ordinances governinc� this type o/ work will be completed <br />rvhefha� specdied herein or not The yranlin�7 0l a pemu( Aoes not nes�m�e to give aulhority ro <br />vio/afe or cancelOie t�rovisions o/any other stafe or local la�v regul�linc� conshuctwn or fhe <br />performance olconstn�cfion. ihaf 1 ant autho�ized by fhe owner oI fhis property fo perform the <br />work lor which applicafion is rnade anA 1 cwnply nilh fhe Stafe Con(ractors Law 18.27 RCW and <br />29G200 WAC. <br />�� <br />` < <, v �---v� ( �..� c�— ���F — n,� <br />FEE <br />?/ISz��.1/ (,l, <br />����,v2U <br />