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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3l 5r S _wr W- nAzll tj <br />PROJECT ADDRESS <br />Owner <br />Mail Addreea City <br />Statamp <br />Phone <br />II II <br />n�scl {z is Boci� <br />3I ScJ Fec141111a�I lJ tvtrcl� <br />C l )t'�c� <br />4l� 3q7-yqi� <br />Tenant <br />Mail Address City <br />Stateoli <br />Phone <br />I <br />�r�e� r� Ff c <br />Z(L ��3T� lshi�ue S ft/OS �aagL <br />1,)A oiaa <br />953-30q-65 <br />ro <br />Electrical Contracta <br />Mail Address City <br />slatemp <br />Phone <br />State License NUmber <br />[eI�A%I 11,%eJ t_ 9- Sri ifi is <br />Proposed Use of Building <br />NOTE: WIRING �N NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />Contract Price of Work <br />7' . 5"YVioYl5 <br />Contact Person (Plan Review) <br />FEE <br />99�ey� <br />1 hem certify thotlI have road and examined this application and know the same to be true and <br />correct. All provist ns of laws and ordinances govoming this typo of wort will be completed <br />whether spe flied herein or not. fie granting o/a permit d' -s notPresume to give authority to <br />violate orRRcancel a ppmvlsio s of any other state or local law mgu PSresume <br />or the J <br />wino", hkhf PPI eo o rode one i otlm ry �nmymo sr""ro con c/orspLaw iB.2a7 R Wtand ��i] <br />to <br />298.2 %WAC i I I `� <br />Signature Oale <br />B/L:a6ed LSeeLS2S2bT:el 6196ST9989 dNl:woad 1;'2:2T TT02-t'0-n0hl <br />